ADDICTED DOCTORS POSE GREAT PERIL FOR THEIR PATIENTS

Reportedly, the number of substance abusers among the American public is
estimated to be 10 percent, while drug and alcohol abuse among medical
professionals ranges from 10 to 20 percent. Some of the reasons given for
the higher incidences among people in medicine are that they are more
susceptible due to their proximity to drugs and they encounter more
work-related stress. Experts report that internists and family
practitioners have the largest number of abusers, while anesthesiologists
tend to have the greatest numbers of practitioners who are completely addicted.

According to the North Carolina Physicians Health Program, there are
currently 150 people being monitored for substance abuse. Since 1988 PHP
has monitored 1,200 professionals, and only 10 percent of those made it
their own choice to enter treatment.

These statistics exemplify the ugly underside of the medical profession and
shatter the age-old myth of the kindly doc who is both the physical and
psychological healer and is above reproach. It is important that medical
professionals' family members and the general public wean themselves from
the sentimentality that distorts the reality of doctors' human limitations.
National Alcohol and Drug Addiction Recovery month, being observed during
September, is the ideal time to examine this life-or-death issue.

People in the medical profession have the same personal pressures as the
rest of us. What is really different about medical professionals and their
patients is not the surface trappings of occupational hazards, but the
hugeness of the stakes for people who entrust their very lives to primary
care physicians and other specialists. As Dr. Paul Martin, an Asheville
addictionologist, points out: "The physician's perception of worth often
depends on the outcome of his patients. So in circumstances where the
patients don't do well, it can be internalized as failure." And Don
Carroll, director of the lawyers assistance program in North Carolina,
says: "If you're trying to help people, you're less likely to be looking
out after yourself. If you have a driven personality, you're less likely to
have consciousness of your own issues."

In an effort to get temporary relief from the pressures of working 14-hour
shifts for seven days or more in a row, many cross the line from occasional
use to dependency. And, just like any addicted person, once they become
aware of their problem, they run scared of losing all they've attained and
tend to neglect the underlying causes of the addiction.

The public is fortunate to have other professionals in the field monitoring
doctors suspected of drug and alcohol abuse. Ninety percent of those who
see treatment programs through to the end actually recover. Some of the
programs entail a one-month stay at an addiction treatment facility, weekly
meetings or 12-step recovery meetings designed especially for health care
professionals. Research shows, however, that the most effective programs
are those that last 6 months to a year and are followed by weekly drug-test
monitoring and one-on-one counseling. In the public interest, this is the
avenue that should be most often pursued. One of PHP's responsibilities is
to provide assistance to medical professionals who would otherwise be
further broken by any cruel assessment of their human inadequacies. The
program's duty also is to protect the public from harm due to
out-of-control health-care providers.

The central, almost sacred relationship between doctor and patient should
not be betrayed in the interest of shielding addicted doctors' inner demons.