Addiction

[Twiggidy]

i'm ambivalent about this. i know we're talking about scheduled substances here but obviously many of the regulars on this forum (including me) enjoy their drink if the "scotch" thread is any indication. not saying we are all alcoholics but there's likely to be a few among us, and really is alcohol in excess any less impairing? i've never had surgery, but if i ever were a pt i think i'd want my anesthesiologist to tell me if they've ever been addicted to booze/drugs and i'd likely request a different doctor.

you should also question your nurses. i wouldn't be shocked if addiction is higher with nurses and I'll tell you right now i know of recover addicts among nursing in my very institution.

i'm a believer in second chances for a lot of things but this one is where I become a hypocrite to myself. the access is way to easy, there are lives (including your own) at stake, and quite honestly, there are people with clean records also looking for residency spots and jobs. a recovering addict is too high a risk compared to someone who isn't an addict (although yes, they could be and i may not know it).

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[Twiggidy]

For those practicing without any hx of abuse, what have you done to prevent it from happening?

Edit: I mean aside from the smart ass "don't use fentanyl" kind of answers.

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Don't do drugs. Join a gym. Take a boxing class. Go to concerts. Snowboard. Ride a bike. Travel. Watch comedies. Develop strong friendships with people with good heads on their shoulders (who also don't do drugs). Cook food. Travel. Build good relationships with coworkers and colleagues

and if none of that works and anesthesia still has you considering drugs...

QUIT.

 

[sciatica123]

Interestingly enough, every CRNA I went to rehab with was back to work within a year some within a couple months. I am not envious and very happy that they got back to work. All are sober still that I know of (but I wouldnt know) and doing well. Just food for thought.

 

[deleted171991]

Interestingly enough, every CRNA I went to rehab with was back to work within a year some within a couple months. I am not envious and very happy that they got back to work. All are sober still that I know of (but I wouldnt know) and doing well. Just food for thought.

That's because the market needs CRNAs much more than it needs anesthesiologists. Life is not fair.

Twenty years from now you will look back and bless the moment you had to change your specialty.

 

[IlDestriero]

Don't do drugs. Join a gym. Take a boxing class. Go to concerts. Snowboard. Ride a bike. Travel. Watch comedies. Develop strong friendships with people with good heads on their shoulders (who also don't do drugs). Cook food. Travel. Build good relationships with coworkers and colleagues

and if none of that works and anesthesia still has you considering drugs...

QUIT.

Yes.
Find healthy ways to reduce stress.
Find relationships and hobbies to enjoy outside of work.
If you have physical or mental issues, deal with them.
I like Scotch as much as anyone, but I like it for what it is, as opposed to self medicating my own problems. If you're self medicating with alcohol, see above, it's a slippery slope.
One of my old colleagues self medicated their PTSD from being in the suck at the worst place at the worst time. They self medicated all the way to a DUI and the unemployment line. They're lucky they didn't kill someone. I would have trouble living with that guilt.


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Il Destriero

 

[Twiggidy]

That's because the market needs CRNAs much more than it needs anesthesiologists. Life is not fair.

Twenty years from now you will look back and bless the moment you had to change your specialty.

This was my first thought when I read the OP's post. All of this literally may be a blessing in disguise. Most importantly, I do hope and wish you the most of luck staying healthy and clean regardless of where your path takes you (Rads.... Path....just sayin'..argument for another thread).

 

[Noyac]

Information from rehab centers:
For anesthesiologists, the prognosis for long-term successful recovery may depend on the age and status of the physician at the time that the abuse is identified. Anesthesia residents who are in recovery appear to have a significant rate of relapse. Other risk factors for relapse are the presence of a prior history of relapse, a history of mental health problems, and the abuse of major opioids such as fentanyl.

 

[IMGASMD]

Information from rehab centers:
For anesthesiologists, the prognosis for long-term successful recovery may depend on the age and status of the physician at the time that the abuse is identified. Anesthesia residents who are in recovery appear to have a significant rate of relapse. Other risk factors for relapse are the presence of a prior history of relapse, a history of mental health problems, and the abuse of major opioids such as fentanyl.

That doesn't sound good for anesthesia residents with this disease.....

 

[epidural man]

OP -

If you DO make it back to anesthesia, please go into Pain Medicine. This will be the safest place. You can get to pain medicine in other routes too.

by the way, a psych friend of mine said that with Obama Care, psych docs are now KILLING it. He makes a lot more than me currently (which was a huge change for him over the last few years).

 

[pgg]

Interestingly enough, every CRNA I went to rehab with was back to work within a year some within a couple months. I am not envious and very happy that they got back to work. All are sober still that I know of (but I wouldnt know) and doing well. Just food for thought.

Return to anesthesia practice in less than a year is itself a big risk factor for relapse, as I recall.

Right up there with
- not self reporting
- abuse of fentanyl or sufentanil
- comorbid psychiatric diagnosis

 

[MalloryWeiss]

OP -

If you DO make it back to anesthesia, please go into Pain Medicine. This will be the safest place. You can get to pain medicine in other routes too.

by the way, a psych friend of mine said that with Obama Care, psych docs are now KILLING it. He makes a lot more than me currently (which was a huge change for him over the last few years).

Interestingly, some residency programs tell their residents that if you are found to have an addiction/abuse problem, after you are rehabilitated the one subspecialty you canNOT go into is pain medicine. Basically - the department would not support your fellowship application.

Does it make sense? Personally, I don't think so.

 

[aneftp]

Interestingly, some residency programs tell their residents that if you are found to have an addiction/abuse problem, after you are rehabilitated the one subspecialty you canNOT go into is pain medicine. Basically - the department would not support your fellowship application.

Does it make sense? Personally, I don't think so.

I agree. It's for the safety of not only the public. But also your own personal safety.

Would you hire a known alcoholic to be a bar manager where access is 24/7 when they are working.

 

[WholeLottaGame7]

I agree. It's for the safety of not only the public. But also your own personal safety.

Would you hire a known alcoholic to be a bar manager where access is 24/7 when they are working.

Disagree. Makes no sense. I don't know if the pain clinic at my residency program even had narcotics on site (I doubt it).

So much easier to divert in an OR setting than a pain clinic setting.

 

[nimbus]

Disagree. Makes no sense. I don't know if the pain clinic at my residency program even had narcotics on site (I doubt it).

So much easier to divert in an OR setting than a pain clinic setting.

But you're surrounded and interact constantly with many opioid and polysubstance abusers.

 

[Aether2000]

I am aware of many pain clinics that keep fentanyl IV in the clinic for procedures and some pain physicians were using this supply. I am also aware of at least three addicted pain physicians that were getting oral opioids from their patients as kickbacks for prescribing. Pain medicine and anesthesiology are poor career choices for prior or current drug (or alcohol) addicts.

 

[IlDestriero]

I am aware of many pain clinics that keep fentanyl IV in the clinic for procedures and some pain physicians were using this supply. I am also aware of at least three addicted pain physicians that were getting oral opioids from their patients as kickbacks for prescribing. Pain medicine and anesthesiology are poor career choices for prior or current drug (or alcohol) addicts.

I think that's the risk in pain, not really diversion. It's easy enough to divert in the OR, but it's easier to get into "special arrangements" with drug seekers, etc. You don't want to be surrounded by that population every day as a recovering addict. They'd do anything to get some opiate prescriptions from you.


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Il Destriero

 

[jwk]

Addiction issues touch way to close to home for many of us. I have several former classmates that have died from fentanyl overdoses, and quite a few former colleagues (of all three types of anesthesia providers) that have left the profession because of addiction issues. The ONLY one of all of these people I know that successfully rehabbed and did not relapse was one who became addicted to PO narcotics many years ago due to legitimate post-surgical/chronic pain issues and dipped into the OR narcotics. He went out for a year for rehab and getting and staying clean, came back, and has had a successful ongoing career for more than 20 years. That being said - the stigma associated with that time of his life has followed him the rest of his career. He has to disclose the problem he had long ago, and he will be the first to tell you that he always feels like he's being watched and under scrutiny for any types of narcotic discrepancies that pop up in his entire department. Other than this one what started out with legitimate prescribed PO narcotics, EVERY one I know that has gotten caught up with this has either 1) relapsed and left the profession or 2) died. Sad.

 

[sciatica123]

And the stigma continues. I have been sober three years and no academic training program will touch me no matter what the specialty. Likely due to stories like the ones about a pain medicine doc trading scripts for narcs. With stories like that why even let someone like me near a prescription pad.

 

[pgg]

And the stigma continues. I have been sober three years and no academic training program will touch me no matter what the specialty.

Have you applied to or considered community programs, or just academic ones?

 

[Pooh & Annie]

And the stigma continues. I have been sober three years and no academic training program will touch me no matter what the specialty. Likely due to stories like the ones about a pain medicine doc trading scripts for narcs. With stories like that why even let someone like me near a prescription pad.

Are you signed up with a physician monitoring board? Programs need to know someone is keeping an eye on you. You'll be MUCH more likely to get a spot

 

[sciatica123]

Are you signed up with a physician monitoring board? Programs need to know someone is keeping an eye on you. You'll be MUCH more likely to get a spot

Ive been in a PHP all three years, fully compliant and have applied to all kinds of programs. I made my bed so I have to lay in it.

 

[IlDestriero]

That's a shame. Best of luck to you.


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Il Destriero

 

[linkin06]

Professional Recovery Network | Discover Life Again

 

[sciatica123]

Professional Recovery Network | Discover Life Again

been involved with one of these for three years. Sadly it has not made much of a difference in terms of advancing my career.

 

[MirrorTodd]

Zombie thread

 

[IMGASMD]

Zombie thread

Thanks. It popped up on my reading list. Then I started to read from the beginning.... to about #20. Then saw your reply.