Medical school, alcohol dependency and the medical profession

Did anything in particular bring on this post? Are you currently fighting an addiction? Do you think you might have one? Catch a friend, classmate, or resident drunk on duty? You don't need to share if you don't want to, of course. I'm just curious what got you worried/angry.

agreed.. why the anger?
also, would you rather have someone drinking every day or smoking pot everyday?

ar2388 said:

agreed.. why the anger?
also, would you rather have someone drinking every day or smoking pot everyday?

Click to expand...

How about neither? What kind of choice is that? Are you suggesting one is better than the other?

no. lol. i was just curious.
i agree that doctors should not be drinking, etc esp while on the job. but this was such a random thread that i thought id make it more interesting.

atkinsje said:

How about neither? What kind of choice is that? Are you suggesting one is better than the other?

Click to expand...

weed is definitely a better option than alcohol. Obviously being under the influence of any substance is not okay in a professional setting...but just in terms of the general use, there are far less accidents and negative consequences from using weed (whether smoked or consumed via an edible) than there is from alcohol use.

I'm not going to argue that inhaling smoke doesn't have negative effects, b/c it does, but something i've thought about is if consuming an edible has any negative effects...has anybody seen a study or article talking about this?

Are you talking about drinking or being completely trashed/wasted? That's different, imo. Because I can always enjoy a good drink with company. Give me a glass of scotch with a fine meal and I don't consider it a problem. Getting drunk on weekends w/ friends? No, not bad. But I know people who are bad, so I can see where it can get to that point. I have an ex friend who would constantly get drunk with a prevailing heart condition; have chronic hypertension/shortness of breath and be scared ot death that she needs to go to the ER .

victoriah said:

Someone I know lost their career as a dentist because of drinking. Their husband also is slowly dying due to excessive smoking/drinking related cancer.

Click to expand...

yes, alcoholism and drug abuse are bad.

Everything in moderation.

engineeredout said:

Everything in moderation.

Click to expand...

Including moderation.

anriar said:

Including moderation.

Click to expand...

lol , it's this moderation thing that gives excuses to drink more alcohol.

medicine1613 said:

God, that really should be a book title, right?

Alcohol. The dirty little secret of medical school. Of course other drugs are very prevalent too, but let's just stick with the most prevalent of them all for now.

Your professors know. Your attendings know. Your deans know. But they all conveniently ignore the problem it actually is. Because to address it would be too difficult. MS1, MS2, MS3 or MS4. It doesn't matter. Only thing that changes as you progress is what days you can drink on without putting anybody but yourself at risk.

There are two reasons why we are the largest group of substance abusing professionals. First off, we are smarter than everyone else. Or at least we think so. Second, our job demands more, creates more stress and is more emotionally straining than any other job out there.

Now before you criticize me as somebody who needs to have their first drink, think again.

Yeah, I'm still a baby when it comes to this profession. But having personally heard the stories of practicing physicians who have abused, I'm not that naive to not know what goes on.

Of course I'm speaking about a minority. But that minority is bigger than you realize. Don't let yourself fall into the trap. And if you do, go seek help.

Click to expand...

I don't know. I think alcoholism is prevalent in every profession. I heard about a couple of Chrysler assembly line workers who got caught on camera drinking and smoking pot during their breaks. Everyone now and then in the news, I'll also hear about a teacher who got caught drinking in the student lounge or an airline pilot who shows up to work with a hangover. The profession is stressful, but I don't think alcoholism is any more or any less prevalent in the medical field than in any other industry.

medicine1613 said:

God, that really should be a book title, right?

Alcohol. The dirty little secret of medical school. Of course other drugs are very prevalent too, but let's just stick with the most prevalent of them all for now.

Your professors know. Your attendings know. Your deans know. But they all conveniently ignore the problem it actually is. Because to address it would be too difficult. MS1, MS2, MS3 or MS4. It doesn't matter. Only thing that changes as you progress is what days you can drink on without putting anybody but yourself at risk.

There are two reasons why we are the largest group of substance abusing professionals. First off, we are smarter than everyone else. Or at least we think so. Second, our job demands more, creates more stress and is more emotionally straining than any other job out there.

Now before you criticize me as somebody who needs to have their first drink, think again.

Yeah, I'm still a baby when it comes to this profession. But having personally heard the stories of practicing physicians who have abused, I'm not that naive to not know what goes on.

Of course I'm speaking about a minority. But that minority is bigger than you realize. Don't let yourself fall into the trap. And if you do, go seek help.

Click to expand...

Thanks OP....

Gheorgia said:

I don't know. I think alcoholism is prevalent in every profession. I heard about a couple of Chrysler assembly line workers who got caught on camera drinking and smoking pot during their breaks. Everyone now and then in the news, I'll also hear about a teacher who got caught drinking in the student lounge or an airline pilot who shows up to work with a hangover. The profession is stressful, but I don't think alcoholism is any more or any less prevalent in the medical field than in any other industry.

Click to expand...

Strong thread to profile pic ratio!

(I'm mirin' that beer...looksgood/10)

I don't feel I need to cut back.
Nor do I get annoyed if people tell me to slow down.
I don't feel guilty about my habit of alcohol consumption.
I never needed an eyeopener.

Not to be a jerk OP- but are you one of those people who thinks that doctors are so high above everyone that they should never get drunk? Because that is ridiculous...

Going out in public and getting blackout drunk- Not good I agree
Being drunk at work- Absolutely not good and grounds for termination


Having a 6 pack after a huge test and partying with friends? FINE!!
Glass of wine with dinner? FINE!!

UAAWolf said:

Not to be a jerk OP- but are you one of those people who thinks that doctors are so high above everyone that they should never get drunk? Because that is ridiculous...

Going out in public and getting blackout drunk- Not good I agree
Being drunk at work- Absolutely not good and grounds for termination


Having a 6 pack after a huge test and partying with friends? FINE!!
Glass of wine with dinner? FINE!!

Click to expand...

I dunno from the way I'm reading into his message he may be the type that thinks ALL people shouldn't drink. I'm not sure if he's really talking about legit drinking problems or classmates who drink 3x a week. Getting trash three times a week while in med school seems difficult and I'd doubt its as common as he says. With that being said I fully realize that alcoholism is a problem in every profession. I worked at a alcohol and drug addiction program in college so I'm aware of it, I'm just wondering if the OP is just judging the drinking habits of his fellow 20 something year old classmates who probably won't all go on to have drinking problems.

I mean if they are able to do their work, not sacrificing patient care, drinking is ok. LOL CAGE questions.

fleetgoddess said:

I dunno from the way I'm reading into his message he may be the type that thinks ALL people shouldn't drink. I'm not sure if he's really talking about legit drinking problems or classmates who drink 3x a week. Getting trash three times a week while in med school seems difficult and I'd doubt its as common as he says. With that being said I fully realize that alcoholism is a problem in every profession. I worked at a alcohol and drug addiction program in college so I'm aware of it, I'm just wondering if the OP is just judging the drinking habits of his fellow 20 something year old classmates who probably won't all go on to have drinking problems.

I mean if they are able to do their work, not sacrificing patient care, drinking is ok. LOL CAGE questions.

Click to expand...

Yes LOL at them . I had an SP at the beginning of the year who was drinking a bottle of wine a night. I decided I should CAGE her (to practice for the real world ). I don't ask those four specific questions in that way but try to talk to a person and see what's going on. She called her husband an *******, said she enjoys drinking wine, and feels that she's in control. Well well well...that wasn't successful.

Yeah I don't think CAGE questions work well in real life just spurting them off as is. I use them a lot on standardized patients on exams though lol. It always feels awkward but since its timed I figure I'll just do it.

Bacchus said:

Yes LOL at them . I had an SP at the beginning of the year who was drinking a bottle of wine a night. I decided I should CAGE her (to practice for the real world ). I don't ask those four specific questions in that way but try to talk to a person and see what's going on. She called her husband an *******, said she enjoys drinking wine, and feels that she's in control. Well well well...that wasn't successful.

Click to expand...

I also like using the phrase CAGE her I commend you on that. I love using that phrase; unfortunately won't be able to use it after this year as I'm going into pediatrics and if I say I caged one of my patients, it would sound bad.

Bacchus said:

I don't feel I need to cut back.
Nor do I get annoyed if people tell me to slow down.
I don't feel guilty about my habit of alcohol consumption.
I never needed an eyeopener.

Click to expand...

But how many times, in say the last 6 months, have you had more than 4 drinks in one "sitting?"

medicine1613 said:

God, that really should be a book title, right?

Alcohol. The dirty little secret of medical school. Of course other drugs are very prevalent too, but let's just stick with the most prevalent of them all for now.

Your professors know. Your attendings know. Your deans know. But they all conveniently ignore the problem it actually is. Because to address it would be too difficult. MS1, MS2, MS3 or MS4. It doesn't matter. Only thing that changes as you progress is what days you can drink on without putting anybody but yourself at risk.

There are two reasons why we are the largest group of substance abusing professionals. First off, we are smarter than everyone else. Or at least we think so. Second, our job demands more, creates more stress and is more emotionally straining than any other job out there.

Now before you criticize me as somebody who needs to have their first drink, think again.

Yeah, I'm still a baby when it comes to this profession. But having personally heard the stories of practicing physicians who have abused, I'm not that naive to not know what goes on.

Of course I'm speaking about a minority. But that minority is bigger than you realize. Don't let yourself fall into the trap. And if you do, go seek help.

Click to expand...

I hope you don't think physicians are exempted from being normal people and need to be some sort of model citizen who doesn't even get a parking ticket. Having a few drinks after an exam to let loose about having spent 3-4 weeks straight studying is pretty normal. What would you have ppl do instead, go to church together? Ridiculous rant IMO. Substance abuse among physicians isn't even all across the board, it's mainly targeted to surgeons, and residents. People who need to find a way to stay up 36 hours in a row and be fully functional. Not that I condone it, but there isn't a way around it. It's just how the system is. 5 cups of coffee, 2 monster drinks, or an adderall, or do it like the old days a line of coke. Take your pick they all do the same damage in the end.

Belleza156 said:

I hope you don't think physicians are exempted from being normal people and need to be some sort of model citizen who doesn't even get a parking ticket. Having a few drinks after an exam to let loose about having spent 3-4 weeks straight studying is pretty normal. What would you have ppl do instead, go to church together? Ridiculous rant IMO. Substance abuse among physicians isn't even all across the board, it's mainly targeted to surgeons, and residents. People who need to find a way to stay up 36 hours in a row and be fully functional. Not that I condone it, but there isn't a way around it. It's just how the system is. 5 cups of coffee, 2 monster drinks, or an adderall, or do it like the old days a line of coke. Take your pick they all do the same damage in the end.

Click to expand...

I really don't think that coffee or adderall are the same of a line of coke. I did forensic path last month and many a people kill themselves on coke, I never saw death by coffee. Additionally it increases your colonic activity and thus MAY reduce colon cancer risk. I work on reducing this risk daily.

But I do agree the rant is a bit preachy, judgmental, and ridiculous.

ar2388 said:

also, would you rather have someone drinking every day or smoking pot everyday?

Click to expand...

smoking pot.

medicine1613 said:

I guess I should stop dancing around this so that I can prove my point. Although I'm not even sure I have a point.

I began med school by going out and getting hammered four times a week. It escalated quickly to six or seven nights a week. Kept that up for the most part over the summer after MS1. Thought it would change during MS2. Everyone says MS2 is so hard and there's not enough time to have a drinking habit like that. Well that's a damn lie. I haven't been able to keep up the pace while studying for boards, but I sure as hell go out more than any of my classmates.

At my peak, I was an 80+ drink a week drinker. I meet every DSM-IV criteria for alcohol dependency, and I am not alone. So yeah, try to help your classmates if you see they may have a problem. I would have loved to have somebody get in my face about this a long time ago. But in the end, you always are responsible for solving your problems yourself.

Click to expand...

Are you drunk right now?

Dont usually go to this part of SDN (as you can see by my handle I am a soon to be podiatry student) but this thread reminds me of a post I saw on that site reddit a while back. After some digging I found it.

http://www.reddit.com/r/IAmA/comments/g8xa7/iama_person_who_has_consumed_close_to_50/

Crazy. I wonder how many others are like this.

medicine1613 said:

I guess I should stop dancing around this so that I can prove my point. Although I'm not even sure I have a point.

I began med school by going out and getting hammered four times a week. It escalated quickly to six or seven nights a week. Kept that up for the most part over the summer after MS1. Thought it would change during MS2. Everyone says MS2 is so hard and there's not enough time to have a drinking habit like that. Well that's a damn lie. I haven't been able to keep up the pace while studying for boards, but I sure as hell go out more than any of my classmates.

At my peak, I was an 80+ drink a week drinker. I meet every DSM-IV criteria for alcohol dependency, and I am not alone. So yeah, try to help your classmates if you see they may have a problem. I would have loved to have somebody get in my face about this a long time ago. But in the end, you always are responsible for solving your problems yourself.

Click to expand...

So did you get help? You said you met DSM IV criteria, not met. My next door neighbor was probably the biggest alcoholic in my med school, it didn't effect his grades but he got in a lot of fights. He gave it up entirely third year. He has a reputation of being really bad but I dont' think he even went out as much as you. You know there are probably people to go to at your institution for this.

Podiatry1 said:

Dont usually go to this part of SDN (as you can see by my handle I am a soon to be podiatry student) but this thread reminds me of a post I saw on that site reddit a while back. After some digging I found it.

http://www.reddit.com/r/IAmA/comments/g8xa7/iama_person_who_has_consumed_close_to_50/

Crazy. I wonder how many others are like this.

Click to expand...

There is a book about high functioning alcoholics, written by one called Drinking A Love Story. It is pretty mind blowing how people can get so much done when under the influence. My stomach kind of hurts thinking about drinking that much though.

I'll send you a PM later today (been through and sober in med school now).

medicine1613 said:

I have gotten help. I don't mess with any other drugs, but alcohol isn't my only problem right now. It's hard to fight multiple battles at once, especially when they work to compound one another.

I can't lie and say my grades haven't been affected. But at the same time, I'm still riding right around the middle of the pack. And if Kaplan and World are doing me right, I'm going to rock Step 1.

I am cocky and arrogant beyond all belief when it comes to this. Part of me is proud of myself for accomplishing what I have while still doing what I have been doing. I've taken quizzes drunk and passed. I've blacked out numerous times the night before an exam and still passed.

I've known I've had a problem with drinking for a little over a year now. But I've never classified myself an alcoholic until now. I can't envision cutting out drinking entirely because it's too big a part of my life now. I am trying to cut back, and have been reasonably successful. But I still slip up far too frequently.

I'll answer any and all questions that avoid giving away too much about myself.

Click to expand...

You should seek professional help right now before going into clinicals or starting a residency. Don't wait until you show up one day and get caught drunk because by then it'll be too late.

Gheorgia said:

You should seek professional help right now before going into clinicals or starting a residency. Don't wait until you show up one day and get caught drunk because by then it'll be too late.

Click to expand...

Hard to get help when he's proud of it..... hopefully he'll hit some bottom before that and chose that its the way for him to go. Hard to respond to... wish you luck is all I can think of.

Ask doctor for Antabuse?

Gheorgia said:

You should seek professional help right now before going into clinicals or starting a residency. Don't wait until you show up one day and get caught drunk because by then it'll be too late.

Click to expand...

I am sorry Gheorgia.. I almost burst out laughing when I read this post and then looked at your avatar.

Alcohol really is a serious problem in medical school and beyond. I can speak from experience as I managed to fail second year due to my drinking. I got help and thankfully managed to get back in (after appearing before my school's review board and explaining what had happened. I was allowed back in but I am part of a monitoring program where I have to attend a certain number of AA meetings per week, meet with a program monitor weekly and submit to random urine tests about twice a month that I have to pay for myself (about $150/mo)).

I see the drinking that goes on at my school and it's out of control. But most think it is just part of med school/youth experience. Quite honestly that's BS. No one plans on ending up with a drinking problem. It has a tendancy to creep up on you. Some students wipe out during the first 2 years of school. Many end up crashing during clinicals because it's harder to hide it when you have to interact and perform on a daily basis. And there are others who make it to residency and it comes out (just heard of a guy this happened to. Was just dismissed from internship).

Some manage to make it to practice when the crap hits the fan. I go to a AA group made up of docs who have addiction problems. You would not believe the hell they went through in order to keep practacing. And I recently heard about a guy (with a wife and kids) who was an addict got help, relapsed, lost everything and killed himself.

Drinking alcohol is a strange thing. You are basically taking a legal mind/mood altering drug. Would we be so accepting of a friend who took a couple of benzos to take the edge off after work? Probably not. But its the same thing.

I worked as a RN in a level one ED and if alcohol were taken out of the picture we would have had very little business. Most traumas have alcohol as a factor. Alcohol/drugs destroys marriages and careers, causes disease, injuries and death, makes you act like a jerk and do things you would not normally due, helps get you arrested, causes DUIs...

Great stuff isn't it.

fleetgoddess said:

I really don't think that coffee or adderall are the same of a line of coke. I did forensic path last month and many a people kill themselves on coke, I never saw death by coffee. Additionally it increases your colonic activity and thus MAY reduce colon cancer risk. I work on reducing this risk daily.

But I do agree the rant is a bit preachy, judgmental, and ridiculous.

Click to expand...

de Balzac - 100 cups of coffee a day (his muse), died of a perforated ulcer.

Sorry, just being a jerk.

I like Coffee, but I don't know why people would drink more than a cup or two.

Isn't it true that coffee potentiates nicotine. A lot of smokers and ex-smokers go bananas for coffee.

2000 Man said:

A
I worked as a RN in a level one ED and if alcohol were taken out of the picture we would have had very little business. Most traumas have alcohol as a factor. Alcohol/drugs destroys marriages and careers, causes disease, injuries and death, makes you act like a jerk and do things you would not normally due, helps get you arrested, causes DUIs...

Great stuff isn't it.

Click to expand...

I disagree. In moderation (defined by the CDC as 2/drinks a day for men, 1/drink women), there are a plethora of papers showing alcohol's benefits in preventing heart disease, prolonging life, and even improving memory. If a person cannot for whatever reason control their intake, all bets are off and alcohol ends up being detrimental. Nonetheless, the literature indicates that mild drinkers have it better off than alcoholics and abstainers.

Take Grannie's wisdom: If you can't hold your liquor, don't drink [so much].

Why is that so hard?

<delete>

medicine1613 said:

Far from anger. More of a "hey, open your eyes and see what's going on around you." I was browsing the forum and saw some comments that just made me laugh and shake my head. Getting drunk once a week, twice a week, three times a week, that's nothing.

And yes, this post stems from my own experiences.

Click to expand...

i've come to refrain from measuring alcohol abuse as a measure of frequency of drinking or quantity drank in a "session." To say "that's nothing," then, is incorrect because it suggests alcohol abuse is a function of frequency of drinking. While you may be able to demonstrate this relationship, don't forget to handle the lurking variables that make it so. The ones in particular that come to my mind are rationale for each drink, hepatic clearance, benzodiazepine-sensitive chloride channel responsiveness to EtOH, and most importantly impairment of day-to-day activities.

Modifications to the aforementioned variables can generate an individual who drinks 7 days a week without feeling "buzzed;" alternatively, it could make an individual who becomes drunk after two drinks of beer. The individual who feels alcohol abuse drinking only 1-3 times a week is likely correct, and that isn't something to discredit simply because you may be able to handle more alcohol.

majik1213 said:

i've come to refrain from measuring alcohol abuse as a measure of frequency of drinking or quantity drank in a "session." To say "that's nothing," then, is incorrect because it suggests alcohol abuse is a function of frequency of drinking. While you may be able to demonstrate this relationship, don't forget to handle the lurking variables that make it so. The ones in particular that come to my mind are rationale for each drink, hepatic clearance, benzodiazepine-sensitive chloride channel responsiveness to EtOH, and most importantly impairment of day-to-day activities.

Modifications to the aforementioned variables can generate an individual who drinks 7 days a week without feeling "buzzed;" alternatively, it could make an individual who becomes drunk after two drinks of beer. The individual who feels alcohol abuse drinking only 1-3 times a week is likely correct, and that isn't something to discredit simply because you may be able to handle more alcohol.

Click to expand...

Cue ridicuously overthought and stupidly analytical reply.

You know if you have a problem with substance abuse, whether the substance is legal or illegal, at this point. If you can't control your life enough to not let it affect work, you deserve what's coming to you.

EgotiStick said:

If you can't control your life enough to not let it affect work, you deserve what's coming to you.

Click to expand...

Have you had any lectures on the topic of substance abuse?

Etorphine said:

I disagree. In moderation (defined by the CDC as 2/drinks a day for men, 1/drink women), there are a plethora of papers showing alcohol's benefits in preventing heart disease, prolonging life, and even improving memory. If a person cannot for whatever reason control their intake, all bets are off and alcohol ends up being detrimental. Nonetheless, the literature indicates that mild drinkers have it better off than alcoholics and abstainers.

Click to expand...

That's a good point, but unfortunately it's more complicated than that. The current thinking is that imbibing alcohol per se does not lend good health more readily than abstinence, rather the *social support* that comes with *social drinking* (not binging!) is what makes it more healthful than abstinence. This is a hot topic in alcohol research right now and many researchers are scrambling to discriminate the effect of social support from moderate alcohol consumption.

~Kalyx