Drug and Alcohol Abuse: Why Doctors Become Hooked

Shelly Reese


May 06, 2015

In This Article

When Doctors Are Impaired, Everyone Suffers

Although doctors may be attuned to signs of their patients' substance abuse issues, they may not be as adept at recognizing and addressing the problem in themselves or their colleagues.

Between 10% and 15% of US physicians suffer from a substance use disorder, a rate slightly higher than that of the U.S. population as a whole.[1] But physicians struggling with abuse or addiction differ from other members of the public in one critical respect: They've taken an oath to care for others.

Physicians Are Good at Hiding the Problem

In most regards, doctors share the same risk factors as anyone else when it comes to substance abuse, in that they're no more or less likely to have a family history of dependence or an undiagnosed mental health problem than, say, a plumber or a banker. But experts say the very nature of medicine and the healthcare workplace may exacerbate the potential for a problem.

Medicine attracts many high-achieving, compulsive, perfectionistic individuals who derive a strong sense of self-worth from their jobs, says John Schorling, MD, a professor of internal medicine and director of the Clinician Wellness Program at the University of Virginia School of Medicine in Charlottesville. If a doctor's commitment morphs into overwork, exhaustion, and a work/life imbalance, alcohol and other drugs may become a dangerous balm.

Physicians' perfectionistic tendencies enable them to perform well in the workplace even as their marriages fail, their personal lives crumble, and their abuse becomes deeply entrenched.

"The big issue is the hiding," says Christopher Welsh, MD, an associate professor of psychiatry at the University of Maryland School of Medicine in Baltimore. "Physicians are very good at hiding their problem."

The environment in which physicians practice often exacerbates the problem, says Doris Gundersen, MD, a psychiatrist in Denver and president of the Federation of State Physician Health Programs Physicians have lost much of the practice autonomy they once enjoyed. They're being overwhelmed with the time-consuming demands of electronic medical records, regulatory requirements, administrative paperwork, and patient care, while being constantly harangued to control medical spending. Collectively, these forces are contributing to an unprecedented level of burnout.


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