DRUG ABUSE BY DOCTORS GROWING

As many as 1,300 Oklahoma physicians abuse drugs or alcohol, statistics
show. One in five is at risk of substance abuse. Driving these statistics,
said Dr. Harold Thiessen, director of the Health Professionals Recovery
Program, are a number of factors -- controlling and perfectionist
personalities, genetics, stress, fatigue and easy access to prescription drugs.

"These tend to be the best and brightest doctors ... who fall prey,"
Thiessen said Thursday during a break at a meeting of the Oklahoma State
Board of Medical Licensure.

Physicians, he said, suffer from two conditions he termed "MDiety" and the
"candy store effect."

"They're highly trained and disciplined to treat illnesses," he said. "So
instead of calling a colleague for help, they tend to want to treat
themselves, and that rarely works. And they really have access to drugs --
like a kid in a candy store."

Physicians often get large supplies of free drug samples and abusers
frequently write illegal prescriptions for themselves, he said.

The licensure board regulates Oklahoma's 5,383 licensed doctors of
medicine. A separate board regulates the state's 1,100 doctors of osteopathy.

On Thursday, the board considered disciplinary action against seven medical
doctors who had been accused of substance abuse violations.

Dr. Orville L. Webb of Lawton and Dr. Terry Rapp of Miami, OK, surrendered
their licenses in lieu of prosecution for drug-related offenses. Other
disciplinary actions or case continuances included Drs. Steven R Marburger,
Kimberly Gage and Elliott H. Howe of Tulsa; Dr. Ricky Joe Nelson of
Oklahoma City; and Dr. Donald Becker of Blackwell.

The board meets again today, and is scheduled to reject the license
reinstatement of Dr. Jeffrey Schimandle of Oklahoma City. He had his
license revoked earlier for drug abuse.

"There's no shortage of business for us," board Executive Director Lyle R.
Kelsey said.

Kelsey said violations are on the rise, which he attributes to colleagues,
co-workers, pharmacists and hospital employees being more willing to come
forward and report doctors impaired by drugs and alcohol.

Of primary concern, Thiessen said, is patient care and how drugs and
alcohol "affect a doctor's ability to practice good medicine."

Thiessen, a recovering alcoholic, said typical cases involve doctors who
initially start using prescription drugs for back pain or other chronic
maladies.

"Then, they begin taking painkillers to treat stress and nervousness, and
they really start liking the euphoria. They start taking more and more, and
before you know it, the drugs affect their behavior and their judgment.

"They have mood swings, irrational behavior and other adverse consequences
from the drugs," Thiessen said.

The Health Professionals Recovery Program, formerly called the Physician
Recovery Program, started in 1983. It has helped about 800 impaired
physicians in 18 years.

The recovery rate is 85 percent, Thiessen said.

The Oklahoma program normally refers doctors to long-term recovery programs
in Florida, Georgia, Illinois, Louisiana, Mississippi, Oregon or Virginia.
Those clinics are designed to treat doctors, business executives, attorneys
and ministers.

Treatment lasts from three months to a year.

After in-patient treatment, doctors in the recovery program must agree to
five years of aftercare that includes random drug screening.

The treatment program is funded by the Physicians Liability Insurance
Program, and the state medical and osteopathic associations.

From February 2000 to June 2001, 12 osteopathic physicians were involved
in long-term, out-of-state treatment prompted by participation in the
recovery program, said Lynette McLain, executive director of the Oklahoma
Osteopathic Association.

"Those who complete the program are better physicians for it," McLain said.
"They are healthier in their own right, and their practices benefit."