Substance Use Disorders in Health Care Professionals

In light of the public's trust, their advanced education, and responsibilities to the public, health care professionals are generally expected by the public to be unaffected by the substances they understand so well, prescribe, dispense and administer. However, like the general population, recent reports to the contrary have highlighted alcohol and drug abuse by health care workers. While understudied, drug abuse by health care professionals is not a new issue as most evidence supports the notion that a small but significant proportion of health care professionals such as dentists, physicians, pharmacists and nurses do use alcohol, tobacco and other addictive drugs resulting in serious consequences to themselves and to the public. A general review of the literature finds that studies of substance use and abuse by health care professionals have often used unreliable outcome measures of substance use, surveyed only one or two of the health professions, used a self-select group or have not studied dentists. The evidence suggests, however, that: (1) past-year use of alcohol and tobacco by health care professionals is less than reported by age-matched samples from the general population; (2) self-reported lifetime drug use by health care professionals is no more than that of the general population, but with greater reported use of prescription medications rather than recreational drugs by health care professionals; and (3) alcohol, tobacco and drug abuse vary somewhat according to the given profession with each health care group having distinct temporal substance abuse histories. Highlighting the various aspects of substance abuse by health care professionals should be a continual educational process starting in college and continuing throughout a clinician’s career.