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| Physicians Health Programs: What Counselors Can Learn from These Remarkable Programs |
| Feature Articles - Treatment Strategies or Protocols | ||||||||
| Written by William L. White, MA,Gregory E. Skipper, MD and Robert L. Dupont | ||||||||
| Wednesday, 27 June 2007 | ||||||||
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Despite their advanced training, physicians are not immune to the
perils of addiction. The prevalence of substance use disorders among
physicians is similar to that in the general population, and
substance-related problems continue to be among the chief reasons
physicians are referred to their licensing boards for disciplinary
action (Flaherty & Richman, 1993; Brewster, 1986; Hughes,
Brandenberg, Baldwin, et al., 1992).
Obviously physicians do not fit the typical, and erroneous, stereotype of addicts (i.e., poorly educated and from lower social classes); however, physicians have their own special risk factors, including easy access to controlled substances and, as a group, relatively high rates of alcohol consumption. Also, physicians entering addiction treatment report particularly high rates of problem complexity, e.g., family histories of addiction, multiple drug choices, co-occurring medical/psychiatric conditions, and other significant obstacles to successful recovery (Domino, Hornbein, Pollissar, et al., 2005). Despite these risk factors, the documented long-term recovery rates for physicians are among the highest reported — between 70 percent and 96 percent (Talbott, Gallegos, Wilson, & Porter, 1987; Gastfriend, 2005; Domino, et al., 2005). This article explores the sources of such high recovery rates, including: active case management, aggressive and prolonged monitoring, contingency management linked to contractually stipulated and clearly defined consequences (not only for return to alcohol or other drugs but also for leaving the monitoring system), plus the requirement of active participation in 12-step programs or other community recovery fellowships. We believe that this comprehensive system of care is worthy of careful examination for components that might be emulated by the addiction treatment system at large (DuPont, McLellan, Skipper, & White, 2006). Addicted physicians: The early history Health care professionals have a long and colorful history of substance abuse in America. Addiction touched the lives of some of the nation’s most prominent physicians, including Dr. William Halsted (1852-1922), the father of scientific surgery in America. The nation’s early medical journals included essays on the treatment of addicted physicians (Mattison, 1883; Crothers, 1899), and recovering physicians played an important role in the birth of addiction medicine, particularly as practiced within late nineteenth century private addiction cure institutes (White, 2000). Although there were physicians, such as Dr. J.T. Mattison, who specialized in the treatment of addicted physicians, there was no larger response to this problem by early medical societies until the late 1800s when medical boards increased in number and developed programs to assure physician competence. Want to read the entire article? Don't miss out...Subscribe now to Counselor Magazine—or buy the single issue! It's easy. Just follow the links below:
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