The California Experience With a Diversion Program for Impaired Physicians

Gualtieri, Antony C.; Cosentino, Joseph P.; Becker, Jerome S.

doi:10.1001/jama.1983.03330260044030

Cited by 29 publications

(8 citation statements)

References 8 publications

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“…Many state impaired physician programs have now negotiated a significant responsibility for the investigation, intervention, and diversion in reported cases of impairment. 33 34 35…”

Section: Legal Issuesmentioning

confidence: 99%

Addiction and Substance Abuse in Anesthesiology

2008

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Despite substantial advances in our understanding of addiction and the technology and therapeutic approaches used to fight this disease, addiction still remains a major issue in the anesthesia workplace and outcomes have not appreciably changed. While alcoholism and other forms of impairment such as addiction to other substances and mental illness impact anesthesiologists at similar rates to other professions, as recently as 2005, the drug of choice for anesthesiologists entering treatment was still an opioid. There exists a considerable association between chemical dependence and other psychopathology and successful treatment for addiction is less likely when co-morbid psychopathology is not treated. Individuals under evaluation or treatment for substance abuse should have an evaluation with subsequent management of co-morbid psychiatric conditions. Participation in self-help groups is still considered a vital component in the therapy of the impaired physician, along with regular monitoring if the anesthesiologist wishes to attempt re-entry into clinical practice.

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“…Many state impaired physician programs have now negotiated a significant responsibility for the investigation, intervention, and diversion in reported cases of impairment. 33 34 35…”

Section: Legal Issuesmentioning

confidence: 99%

Addiction and Substance Abuse in Anesthesiology

2008

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“…ported by programs treating physicians varies from 77% 40 to 93%. 41 Even with these optimistic reports, the possibility of a temporary relapse must be anticipated.…”

Section: Signs Of Substance Abuse and Dependencementioning

confidence: 99%

Substance-Related Disorders Among Anesthesiologists

Katz

Hines

2005

Advances in Anesthesia

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“…Published studies have reported varying but generally high rates of success for physicians in treatment and monitoring programs (TABLE ). 35,[38][39][40][41][42][43][44][45] However, there are no comparative trials and virtually all reports are based on studies in relatively small, nonrepresentative samples drawn from a single state treatment or monitoring program. In addition, follow-up intervals and definitions of success and methods of assessing it have also varied widely.…”

Section: Box Principles Of Directive Interventionsmentioning

confidence: 99%

A 35-Year-Old Physician With Opioid Dependence

Knight¹

2004

JAMA

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Dr L was well until several years ago, when he was grieving after a stressful life event. He began taking antidepressant medication from the sample closet in his office. He stopped taking the medications after several months because he had no relief from his symptoms. Gradually, most of his grief symptoms resolved. Some time later, Dr L became ill with an upper respiratory tract infection. Again, he self-treated his symptoms, this time with a cough syrup containing hydrocodone that he obtained from his office sample closet. The hydrocodone improved not only his cough but also his mood, and he began to take it regularly to get through the day, even after his cough resolved. It allowed him to function at a level he perceived as higher than his normal baseline: he was productive, attentive, happy, and energized. He began requiring more and more of the hydrocodone to achieve these effects.Dr L continued to use hydrocodone from his sample closet, going through numerous bottles weekly. He wrote prescriptions for the medication in tablet and liquid form so that he would have a back-up supply when the sample closet became empty. At one point, while he was out of town and away from his medication, he told his unsuspecting wife about his addiction, and he stopped using. When he had not taken hydrocodone for more than 36 hours, he experienced significant withdrawal symptoms that included anxiety, fatigue, and depression. To diminish them, he began taking hydrocodone again (without his wife's knowledge) within a week of returning to work. At that point, he realized that he had a problem with addiction but did not seek help. Ultimately, he was taking about 200 mg per day of hydrocodone. During this entire 18-month course, Dr L did not seek medical care.Approximately 6 months later, and after about 2 months of suspicions related to observed mood changes and categorical denials that anything was wrong, his employer confronted him about his drug use. He was referred to the state physician health

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The California Experience With a Diversion Program for Impaired Physicians

Cited by 29 publications

References 8 publications

Addiction and Substance Abuse in Anesthesiology

Addiction and Substance Abuse in Anesthesiology

Substance-Related Disorders Among Anesthesiologists

A 35-Year-Old Physician With Opioid Dependence

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