Why physicians abuse prescription drugs
A new study reveals that physicians who admit to abusing prescription drugs report that the top reason for doing so is to self-medicate in an effort to help them cope with pain and emotional issues.
The study, published in the Journal of Addiction Medicine, involved a group of substance-abusing medical doctors who anonymously took part in group discussions that were monitored by a Florida state physician health program (PHP).
The doctors said that they not only self-medicated to help with physical pain and emotional problems, but also to manage stress and prevent symptoms of withdrawal. They also admitted to abusing medications for recreational purposes.
Of the prescription medications that were abused most often by the physicians, the two most common were opiate painkillers and sedatives.
Lead researcher Lisa Merlo, PhD, of the McKnight Brain Institute and the University of Florida in Gainesville, said that substance abuse among physicians is “a small but serious problem” that has major consequences for both the patient and the public.
The research team also pointed out the importance of prevention initiatives, which they said should start in medical school by educating students about the problem of prescription drug abuse among physicians, as well as requiring continuing education courses on the subject throughout their medical careers.
How many physicians struggle with a prescription drug problem during their lifetime?
According to the research team, the number of physicians who will experience a substance abuse disorder is between 10 to 15 percent. While this percentage is about the same for the general public, the study found that medical doctors seem to misuse prescription drugs more often than the general population.
The researchers added that understanding why more doctors misuse medications "would help educators, administrators, colleagues and providers more successfully identify, treat, and monitor addicted physicians."
The study involved 55 prescription drug-dependent medical doctors who were participating in a Florida PHP. The majority of the participants were men (94.5 percent) with an average age of 53 years. Most of the physician participants were white (72 percent), with 21 percent Latino and 7 percent “other”.
Among them, 21.8 percent of the participants practiced family/general medicine, 16.4 percent listed their specialty as internal medicine, 14.5 percent anesthesiology, 14 percent surgery, and 10.9 percent practiced psychiatry. The remaining specialties were listed as either pediatrics, obstetrics/gynecology or other.
All of the participating doctors took part in guided group discussions between December 2008 and March 2009 – and prior to that time, they completed questionnaires that asked about the physicians’ drug misuse, including patterns of dependence and their work history.
As a result, the study found that 69 percent of the doctor participants had abused prescription medications at some point in the past. The rest of the docs said they only used alcohol and/or illicit drugs, but all of the docs who admitted misusing prescription drugs also had a history of alcohol and illicit drug use.
Many of the doctors reported abusing drugs to self-treat emotional pain and/or psychiatric symptoms, and the reason why was because they did not trust the recommendations of their treating physician.
Several of the docs also reported self-medicating due to stressful matters related to work and personal problems, such as malpractice claims, financial problems and/or struggles balancing career-child responsibilities.
Interestingly, recreational use also played an important role that contributed to substance misuse among the doctors, as many of them admitted they often used prescription meds to enhance the effect of another substance.
Misusing prescription drugs was also frequently cited as a means of preventing or reducing painful withdrawal symptoms, which the researchers said appeared “to become more salient to the physicians” as their problem with addiction got worse.
SOURCE: Journal of Addiction Medicine, Reasons for Misuse of Prescription Medication Among Physicians Undergoing Monitoring by a Physician Health Program, Merlo, Lisa J. PhD, MPE; Singhakant, Supachoke MD; Cummings, Simone M. PhD, MHA; Cottler, Linda B. PhD, MPH (October 2013); doi: 10.1097/ADM.0b013e31829da074