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Editorial
March 23/30, 2005

Physician Substance Abuse and RecoveryWhat Does It Mean for Physicians—and Everyone Else?

Author Affiliations
 

Author Affiliations: Addiction Research Program, Department of Psychiatry, Massachusetts General Hospital, and Department of Psychiatry, Harvard Medical School, Boston, Mass. Dr Gastfriend is now vice president of medical affairs, Alkermes Inc, Cambridge, Mass.

JAMA. 2005;293(12):1513-1515. doi:10.1001/jama.293.12.1513

The 10% to 15% prevalence of substance use disorders among physicians is similar to that in the general population,1,2 but the quality and intensity of treatment given to physicians may far exceed that available to other individuals with these disorders.35 Recognition of the impaired physician began to emerge only in the 1970s6 and has led to the development of physician health programs (PHPs). These are now mature models, available in many states, usually through medical societies, as an alternative to monitoring by state government boards of registration in medicine.7 In many cases, physicians who voluntarily contract with a PHP may remain anonymous7 to the state medical board and the National Practitioner Data Bank, a feature designed to promote early intervention in the disease process, ie, before patients are harmed. Many PHPs now offer services to other health professionals also. Treatment in these programs is probably the most comprehensive available for the disease,8 likely to include a full continuum of care, longitudinal (1- to 5-year) management, contracting for treatment and mutual help group (eg, Alcoholics Anonymous) participation, frequent assessment, random urine testing with observed micturition, hair testing for abused substances, and workplace surveillance.9

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