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Substance Abuse in Surgery
Providers with alcohol and drug problems put themselves, and their patients, at risk.
Ashish Sinha
Publish Date: May 25, 2016
OR Excellence
Ashish Sinha, MD, PhD, MBA Ashish Sinha,

Speaker Profile

  • Board-certified anesthesiologist practicing at Hahnemann University Hospital in Philadelphia, Pa.
  • Developed interest in substance abuse among professionals after watching 2 colleagues fall prey to addiction.
  • Has authored or co-authored more than 100 manuscripts and delivered more than 600 CME lectures on 6 continents.

Healthcare providers are just like everyone else: which is to say, they're human and vulnerable to flaws and temptations, including alcoholism and drug abuse, says Ashish C. Sinha, MD, PhD, MBA, vice chairman of the anesthesiology and perioperative medicine department at Drexel University College of Medicine in Philadelphia, Pa. In his presentation, "Addiction & Abuse: Medicine's Dirty Little Secret," he'll explain why providers may in fact be more vulnerable to addiction, and he'll outline the options available to help them recover.

  • No one is immune. Addiction among medical professionals shouldn't be a surprise. We expect healthcare providers to be somehow cut from different cloth, but believe me, they're not. They aren't immune to addiction or abuse. Their work is stressful and involves long hours, and their relatively easy access to prescription painkillers and other potent medications may make drug diversion even more likely.
  • 1 in 10. The incidence rate of substance abuse among providers might be more than 10%.
  • When does it strike? Drug use is more likely to emerge a number of years after training. Look at physicians. As a med student, as a resident, you can't be a drug addict. You'll flunk out. But 3 to 5 years post-training is when this tends to begin. You may be depressed, you may be curious. Anesthesia especially has access: Open the drawer and the good stuff is right in there. How do you know that the pharmacist who sends syringes to the OR isn't skimming? And who's going to watch over our shoulders all day? It's not as though you can have a camera pointed at everybody in the facility that handles drugs.
  • Hidden in plain sight. A critical risk with our substance-abusing colleagues, especially those with whom we've worked closely or over the long term, is that we may start rationalizing their behavior and making excuses for them. "John's acting weird because he and Mary have been having problems." There are warning signs, and we should be acting on them. Substance abuse has a progressive effect, and left untreated it can be fatal. Besides the obvious risks to patient safety, narcotics quite literally take away the body's desire to breathe.
  • Facing facts. There are a number of reasons why providers may hesitate to ask for help. From a physician's viewpoint, there's an overachiever's invincibility syndrome ("I can quit any time") and a massive sense of self-worth locked up in the educational and professional levels they've reached. An arrest, a revoked license would cost us our income and our ability to help people. The shame, embarrassment and financial fallout make it difficult to declare an addiction. But isn't walking up to the chief and saying, "I've got a problem, and I need help," better than being found out, or found comatose or dead with a needle in your arm?
  • Road to recovery. Recovery is hard but it's possible, and the prognosis for complete recovery is good. Addiction treatment programs work, especially when they include peer monitoring, oral opiate blockers, and support from family and friends. Research shows that anesthesiologists who are clean for 1 year have a 90% success rate from then on. That's only 1 in 10 falling back into substance abuse. After 2 years, it's 98%, or 1 in 50. OSM