Cath Lab Management

Addiction Disorders in Allied Health Professionals: A Treatable Disease

Michael Wilkerson, MD
Michael Wilkerson, MD
A common misperception is that an allied health professional who is suffering from an addictive disorder to drugs or alcohol is usually clinically incompetent and easy to identify. The fact is, however, job performance is usually one of the last indicators manifested by an addicted allied health professional. Therefore, many allied health professionals continue to practice excellent medicine while suffering from an addictive disorder. Nevertheless, there are many clues that can help identify a colleague who is addicted. Addiction is a disease that can affect all aspects of an individual’s life. Listed below are some of the signs and symptoms of alcoholism or drug addiction in five areas: Community Isolation and withdrawal from community activities, leisure activities and hobbies, and church, friends, and peers Embarrassing behavior at a club or parties Arrests for driving while intoxicated, legal problems Unreliability and unpredictability in community and social activities Employment Numerous job changes in the past five years Complicated and elaborate medical history Unexplained intervals between jobs Indefinite or inappropriate references Reluctance to undergo immediate pre-employment physical examination Family Withdrawal from family activities, unexplained absences from home Development in spouse of disease of spousaholism (This is another term for enabler. The spouse covers for the affected individual i.e., makes excuses for his/her behavior or calls in sick for him/her.) Abnormal, antisocial, illegal behavior by children Sexual problems, i.e. impotence, extramarital affairs Physical Status Deterioration in personal hygiene Numerous prescriptions and drugs Accidents Emotional crises Hospital Disruption of appointment schedule Hostile, withdrawn, unreasonable behavior to staff and patients Absence from work unexplained or due to frequent illness Decreasing quality of performance Reports of behavioral changes from hospital personnel (hospital gossip) When an allied health professional is believed to possibly have a chemical dependency problem, it is important to know how to intervene. Available resources can include the allied health professional’s hospital, which should have a policy on how to address identified professional impairment within the organization. Many such policies direct the individual about whom there is concern to an Employee Assistance Program (EAP). Another resource is the state's physician’s health program, which specializes in helping with impaired health professionals. Information regarding each state’s PHP can be found on the American Medical Association website link, Federation of State Physicians Health Programs. Addiction specialists on staff at treatment centers who regularly treat impaired physicians (for example, Talbott Recovery Campus) can also provide valuable information on how to effectively intervene. Once the allied health professional has been intervened upon and the diagnosis of addiction made, it is very important that he or she obtain proper treatment. Although each treatment alternative must be individually assessed, previous studies suggest that allied health professionals have much better outcomes when treated at centers that provide a healthcare provider peer group milieu, the opportunity for prolonged residential treatment (approximately 3 months), family involvement and specialized continuing care. After the allied health provider is discharged from treatment, it is important that he or she participate in an aftercare monitoring program. Most aftercare programs require random urine drug screen monitoring and attendance at 12-step meetings (i.e., AA meetings). These programs typically last for five years. Numerous studies have demonstrated that effective treatment, coupled with monitoring, lead to success rates for continued recovery that approach ninety percent for the five years following discharge from treatment. There is no doubt that chemical dependency among allied health professionals is a significant problem. However, great strides have been made over the last fifty years to help identify and aid those individuals suffering from the disease of addiction. The once prevalent paradigm of discipline is slowly being replaced by the paradigm of a very treatable, medical disorder. We have already learned that when this medical disorder is properly treated and monitored, high success rates can be achieved. Those of us who work in the addiction field have also learned that participating in the metamorphosis that occurs when the lives and careers of our addicted colleagues' are saved is immeasurably rewarding.
References
1. Talbott G.D. Prevalence of Alcohol and Other Drug Problems Among Physicians. JAMA 1987;257(21):2927-2930.

2. Skipper GE. Treating the Chemically Dependent Health Professional. Journal of Addictive Diseases, Vol. 16(3) 1997: 67-73.

3. Gallegos KV. Relapse and Recovery: Five to Ten Year Follow Up Study of Chemically Dependent Physicians-The Georgia Experience. Maryland Medical Journal. 1992;44(4): 315-319.