Addiction and Substance Abuse in Anesthesiologists - Research Paper Example

?Running head: Addiction and Substance Abuse in Anesthesiologists Insert Insert Grade Insert 17 November Addiction and Substance Abuse in Anesthesiologists Introduction Anesthesiologists practice anesthetics in the anesthesiology field of medicine, by providing continuous health care for patients. Anesthetic involves several stages including preoperative evaluation care, intraoperative care, and postoperative care. Nevertheless, the field of anesthesiology has come a long way; for instance, in the mid 19th century, when it began its operations, limbs would be amputated and teeth were extracted when the patient was fully awake (Zengerle, 2008, p.21). However, with the advances in technology, administering of drugs such as morphine and ampule among other drugs silences the patient to sleep or sooths the pain away. In addition, this field of practice involves several sub-specialties - pain management, critical care, pediatric care, and obstetrical care among others. Physicians in this field face a variety of challenges while in practice, one of them being addiction to various substances such as opioids, fentanyl, and sufentanil (Ethan et al, 2008). Substance abuse involves the continuous use of drugs despite their negative consequences. However, some substances are rarely abused by anesthesiologists such as propofol, nitrous oxide, and ketamine among others, but these substances are prone to abuse. Moreover, the affected and impaired anesthesiologists should be assisted in overcoming addiction and substance abuse by qualified personnel. Generally, addiction and substance abuse can be influenced by work environment conditions, especially if they lead to stress ad pressure. In addition, peer influence can also induce addiction, as well as curiosity about the patient’s experience, which can trigger the desire by anesthesiologists to experiment the drugs on their bodies. This paper will analyze substances abuse at length and the level of addiction existing in anesthesiologists. Addiction and substance abuse According to Ethan et al (2008), substance abuse is common among anesthesiologists; drug abuse in this particular group involves large quantities of highly addictive drugs. In addition, the stressful environments in which anesthesiologists operate in contribute to the substance abuse. The authors further argue that, research has proved that substance abuse is higher in anesthesiologists compared to other specialties. In addition, other studies have shown that drug related deaths are common among anesthesiologists, especially after the first five years following graduating from medical school. Moreover, the rate of addiction in anesthesiologists remains high compared to that of other physicians. Nevertheless, some drugs of abuse are associated with activating the reward structure in the brain, thus resulting to permanent changes in behavior, which are reflected in the neuron physiology. Ethan et al. (2008) argue that, a research in 1991 revealed that 57 out of 100 substance abusers were found with personality disorders as well as chemical dependence. Observations prove that individuals with the same personalities were found to abuse drugs of the same class; for instance, opioids were found to be mostly used for depression and anxiety, whilst amphetamines were used in hyperactivity and deficit situations. Due to the high rate of chemical dependency, the addicted anesthesiologist gains an extra-ordinary attentiveness at the place of work, since he maintains a close accessibility to the source of drugs. However, change in behavior is evident with time such as, depression, anger, europhria, and irritability (Ethan et al., 2008). Some of the changes common in the affected anesthesiologists include: Withdrawal from family and social life Frequent depression d mood swings Long periods of anger and depression Weight loss Spending more time in the hospital even while on off duty. Zengerle (2008, p.21) explains the case of Brent Cambron, who worked in a medical center, where he would inject his patients with ampule or fentanyl, especially if the patients developed panic before surgery. These drugs would sooth the patient to a calm and painless environment even after surgery. However, Cambron developed the urge of experiencing the sensations that his patients experienced as a result of these drugs. He therefore started injecting himself with morphine often, despite this being an illegal act. This is one such example that explains the process of substance abuse in anesthesiologists. Zengerle (2008, p.21) describes the practice as harrowing, since anesthesiologists have to put a patient to sleep before surgery when maintaining their physiological balance. This is because the drugs used to put the patient to sleep tend to slow their heart rate and blood pressure as well. Other forms of surgery also require silencing a patient’s brain and paralyzing his muscles, in such a case, the anesthesiologist is required to control breathing of the patient. The anesthesiologist takes over the role of preserving a patient’s life; this is a horrifying process, as any bladder would cost a patient’s life. Despite anesthesiology having come a long way with the aid of technological advances, the main problem lies with its practitioners who develop substance abuse and addiction. Zengerle (2008, p.22) explains that the journal of American medical association published by Talbott proved, that despite anesthesiologist comprising of 5% of the physician population, they amounted to 13% of those treated with drug addiction. In addition, the younger physicians were more affected compared to the rest. In 2005, a study that surveyed more than 100 anesthesiology residence programs confirmed that between 1991 and 2001, 80% of these programs reported cases of drug addictions, whilst 20% reported deaths related to overdose or suicide. Alcohol addiction is also evident among these physicians; however, substance abuse in physicians has more weight. According to Merlo & Gold (2009), addiction is categorized by impaired control of drug use and over consumption of alcohol, which results to distortion in thinking and denial among other consequences. The authors insist that, the recognition of addiction as a disease rather than a behavior has contributed to various development of effective treatment, thus reducing the stigma tandem with rehabilitation process. Figure 1: signs of physician substance abuse (Source: Merlo & Gold, 2009) Factors that contribute to addiction and substance abuse in anesthesiologists Merlo & Gold (2009) describe several factors that contribute to anesthesiologists’ addiction. The first is the fact that these physicians have ready access to drugs and their ability to self-prescribe these drugs. The rate of drug abuse in these physicians is higher compared to cigarette smoking, however, only a number of anesthesiologists have the addiction problem. Secondly, work related stress has also contributed to physician addiction; however, these physicians have a tendency of denying the use of drugs as self-medication. They however insist that these drugs are for euphoric effects. Nevertheless, it is believed that this addiction results from small amounts of addictives substances that are either inhaled or injected through the skin. This hypothesis explains why opioid abuse is common in anesthesiologists and surgeons too; this is mainly due to easy accessibility of drugs. Thirdly, an individual’s family history of substance abuse can contribute to addiction at a later life; but anesthesiologists perform drug experimentation on themselves, leading to the development of addiction. In addition, discord in a physician’s personal life such as a divorce or separation with a spouse can also contribute to the development of substance abuse. Moreover, substance abuse may be triggered by curiosity about the patient’s experience, hence giving the anesthesiologist the desire to try out these drugs. This in return affects negatively the lives of his children who may develop psychological problems and result to substance use. Drug addiction can also lead to accidental deaths, loss of job and medical license; it may also result to domestic violence, all these being factors that bring out the need for treatment. According to Thomas & Carter (2006, p.184), an estimate of 1 in 15 physicians is likely to suffer from drug dependence; the anesthesiologist nature of giving drugs directly to patients rather than prescribing the medication gives them the authority to access a wide variety of drugs. Nevertheless, the nature of their jobs proves that any mistakes have severe consequences; hence resulting to drug addiction and substance abuse for comfort purposes. In addition, returning to the same place of work after treatment can be a difficult decision, especially if the place of work is a contributing factor to the anesthesiologist problem. The impaired anesthesiologists are also at risk of malpractices, which could result to negative consequences. Ethan (2008) also explains that institutions are expected by law to report any cases of addictive behavior, failure to which may result to law bending depending on different countries. It is however important for any cases of substance abuse to be reported earlier enough to allow for immediate treatment, therefore leaving no room for malpractices. Treatment of impaired anesthesiologists According to Merlo & Gold (2009), physicians display quality health compared to the general population; however, this factor does not protect them from substance abuse and chemical dependence. There is need for treatment for the affected physicians who are impaired at some point of addiction. The identification of a problem is the initial step towards recovery. The avoidance of treatment only hinders the success of the impaired physicians (Merlo & Gold, 2009), who can recover successfully in a treatment program focused in treating healthcare professionals. Such an environment can foster quick recovery since it abates the shame due to the presence of other peers. Bryson & Silverstein (2008, p.910) insist that, creating an effective environment for the impaired individual enables affected physician to get support from similarly affected physicians. Such programs involve recreational therapy and group therapy sessions; such a program aims at isolating the affected medical professionals from the general population. According to Editorial (2009, p.576), anesthesiologists are leading in chemical dependency treatment and monitoring programs, hence accounting to almost 15% of the population subjected to this kind of treatment. However, several authors believe that addiction is as a result of easy accessibility of the drugs. Nevertheless, the successful completion of treatment does not guarantee that relapse will not occur (Editorial, 2009, p.577). Indeed, the anesthesiologists can return to their place of work after treatment, only under monitoring program and random testing (Thomas & Carter, 2006 p185). Merlo & Gold (2009) suggest that, group dynamics are a powerful tool in treating these physicians, whereby, patients are provided with opportunities of confronting denial, hence learning from their peers’ experiences. However, there are barriers that may hinder application of treatment; denial is the first factor that physicians use to justify their behavior. In addition, occupational success, which is related to independence, may contribute to dismissal of the problem. Many physicians with an addiction problem hide the problem, hence making it difficult for others to detect. In addition, the anesthesiologists with the problem may also be reluctant to seek medical attention: family members also contribute to the denial factor by choosing to ignore the physician problem rather than addressing the problem. Conclusion Addiction and substance abuse among anesthesiologists is a common practice. Various authors have argued on its causes, some concluding that the easy accessibility of abused drugs could be a contributing factor, whilst others blaming addiction and substance abuse on the harrowing and stressful nature of anesthesiologists’ jobs. Their jobs involve regulating the patient’s heart rate and keeping them stable throughout an operation; these are challenging tasks, where any mistakes could have serious consequences on a patient’s life. Nevertheless, the impaired anesthesiologists can survive this addiction through various treatments provided by professionals. However, authors have found a challenge in returning to the same place of work after recovery; mainly because the place of work is viewed as a contributing factor to the anesthesiologist’s cause of problem. In addition, denial is viewed as one of the hindrances towards recovery; however, denial is not limited to only the addict, family and friends may choose to ignore the impaired anesthesiologist too. References Bryson, E. & Silverstein, J. (2008). Addiction and substance abuse in anesthesiology. The American society of anesthesiologists Inc. Retrieved from http://mountsinai.academia.edu/EthanBryson/Papers/104584/Addiction_and_Substance_Abuse_in_Anesthesiology. Editorial. (2009). Anesthesiologists Recovering From Chemical Dependency: Can They Safely Return to the Operating Room? Mayo clinic proceedings, 84(7); 576-580. Ethan, B. et al. (2008). Addiction and Substance Abuse in Anesthesiology. Journal of the American society of anesthesiologist, 109(5); 905-917. Merlo, L & Gold, M. (2009). Successful Treatment of Physicians with Addictions. Addiction Impairs More Physicians than Any Other Disease. Retrieved from http://www.psychiatrictimes.com/addiction/content/article/10168/1444802. Thomas, I. & Carter, J. (2006). Occupational hazards of anesthesia. Continuing Education in Anesthesia, Critical Care & Pain, Vol. 6 Issue 5, p182-187. Zengerle, J. (2008). Going under: A doctor’s downfall and profession’s struggle with addiction. Retrieved from http://www.tnr.com/print/article/health-care/going-under. Read More