Health Care Professionals Aren't Immune to Addiction

A Q&A with Marc Myer, MD on Understanding the Prevalence, Barriers and Treatment Options

Interview with Marc Meyer

Marc Myer, MD, director of the Health Care Professionals Program at Hazelden in Minnesota. As a board certified addiction specialist, Dr. Myer specializes in helping physicians, nurses, and other health care providers find freedom from addiction. He is a Diplomate of the American Board of Addiction Medicine and serves on the executive committee for Physicians Serving Physicians in Minnesota.

How prevalent is addiction in the health care profession?

While the lifetime prevalence of addiction among health care professionals is similar to that of the general population—estimated at between 8 and 13 percent—there are some distinctions. Surgeons, especially female surgeons, have significantly higher rates of alcohol use disorders than the general population. The other dissimilarity relates to types of substances misused. Physicians are five times more likely to abuse opioid pain medications and benzodiazepine anti-anxiety drugs than the general population, which is attributable, at least in part, to greater access to and familiarity with those substances.

What barriers do health care professionals face in seeking help for addiction?

Addiction is an illness driven by guilt and shame—even more so for health care professionals. The physicians and nurses I work with in treatment are wracked with guilt about having this disease. There are behavioral aspects of addiction that cause extreme shame, which leads to deeper isolation. Fear is another powerful barrier. Fear about the consequences of admitting to addiction. Fear about loss of career, loss of license, and loss of respect among colleagues and patients. Health care professionals often feel like they have too much at stake to get help. The truth is, there's too much at stake to not get help.

In terms of personality profile, it's not unusual for health care professionals to have taken on a caretaker role from a young age. That means many physicians and nurses are predisposed to caring for others, often at the expense of caring for themselves. It's part of what draws many health care professionals into the field.

Are there unique addiction treatment challenges or issues for health care professionals?

Definitely. When you've spent your entire career taking care of patients, it's difficult to adopt the patient role—to be vulnerable and willing to receive help. Health care professionals tend to enter addiction treatment at a later stage of the disease because their denial structure is so fortified; the walls have been built up through the sacrifice and determination it takes to achieve a career in medicine. Being in a treatment environment with a cohort of health care professionals—colleagues who understand the workplace dynamics, pressures, and obligations—allows for those walls to start coming down.

Does stigma play a role in facing addiction, compared with other chronic conditions, such as heart disease or diabetes?

Very much so. Stigma weighs heavily even though addiction has been recognized as a disease by the American Medical Association for decades. Like other chronic diseases, addiction can be treated and managed successfully. And for health care professionals, recovery outcomes are extremely impressive. Physicians who complete an addiction treatment program and engage in ongoing monitoring and return-to-practice planning have recovery rates as high as 90 percent at three to five years post-treatment.

What advice do you have for health care professionals who think they might have an addiction problem?

You don't need to self-diagnose. You can find help and answers, confidentially, from professionals who will assist with assessment, evaluation, and referral services. Many have access to state agencies that coordinate diagnosis, treatment, and monitoring services for health care practitioners. Addiction is an isolating disease, especially for health care professionals. But it's safe to reach out for help. And it's effective. The vast majority of health care professionals who complete addiction treatment at the Hazelden Betty Ford Foundation are able to successfully restore their careers.

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