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Drug Addicted Doctors - The Junkie in the OR

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TriagePreMed

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http://www.menshealth.com/health/junkie-or

This is from 5 years ago... but do you think med schools should drug test all candidates?

You could be training a drug addict to practice dangerous medicine...

Thoughts?
You could also be training someone that in 5 years will become a drug addict.

I think what you put in your body is your personal freedom. If you do it at work, you will eventually get caught.

What would a drug test accomplish other than make a few kids stop smoking pot a month or two before their drug test? Things like coke only last 3 days in your system, so it's not like a drug test policy will be that great.

Also, alcohol is probably more of a problem. Ban doctors from buying it?
 

Tapepsi

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I agree with TriagePreMed. I think alcohol is an even bigger problem. Unfortunately there's really not much that can be done to prevent this. When you have a field that has a lot of stress it makes logical sense that there are people engaging in substance abuse.
 

FattySlug

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I personally know two doctors, one surgeon one internist, who do ecstasy pretty often. From what they are saying, it is fairly common in the medical field.
 

SitraAchra

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I had to take a pee test before starting my anesthesia residency. Not sure how common it is.
 

Carnation1895

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I think screening candidates for addiction "risk factors," a la MMI/personality test, might make more sense. And further reducing the demands of residency and everyday practice to a more "human" level. Are either of those feasible? I don't know.
 

Kaustikos

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    http://www.menshealth.com/health/junkie-or

    This is from 5 years ago... but do you think med schools should drug test all candidates?

    You could be training a drug addict to practice dangerous medicine...

    Thoughts?

    Because it's so difficult to pass drug tests... There are ways to circumnavigate these tests and I'm pretty sure pre-allos/med students would find those ways FAST. I don't see the point.
     

    luli

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    They could do a follicle test and get results for 90+ days on any drug (that they test for--I don't believe they typically test for LCD/mushrooms and the like). They can use hair from anywhere on your body, not just your head.

    Should they? I don't think so, unless they have reason to suspect that a student is showing up to a clerkship on drugs (for instance).

    If someone wants to smoke pot occasionally in their off hours then that should be their private decision to make. It mostly just makes me hungry and lethargic, but to each his own. Alcohol is way more of a public nuisance IMO, and it's legal.
     

    CodeBlu

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    They could do a follicle test and get results for 90+ days on any drug (that they test for--I don't believe they typically test for LCD/mushrooms and the like). They can use hair from anywhere on your body, not just your head.

    Should they? I don't think so, unless they have reason to suspect that a student is showing up to a clerkship on drugs (for instance).

    If someone wants to smoke pot occasionally in their off hours then that should be their private decision to make. It mostly just makes me hungry and lethargic, but to each his own. Alcohol is way more of a public nuisance IMO, and it's legal.

    Sure alcohol is legal... but no doubt it causes problems. When you have a hungover doc coming in to perform surgery on you... would you want that guy/girl cutting you up? I wouldn't.
     

    CodeBlu

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    I think screening candidates for addiction "risk factors," a la MMI/personality test, might make more sense. And further reducing the demands of residency and everyday practice to a more "human" level. Are either of those feasible? I don't know.

    Reducing the demands of a residency... that wouldn't work. The quality of teaching would disappear... I bring up an example.

    Duty hours... are 80 some hours right now. Imagine you're on call with 70 patients to take care of... some of them you've never laid an eye on. Mrs. Smith has a special surgical procedure, and is recovering... but at 2am she's not producing urine. Instead of sifting through the chart properly and going to examine the patient physically, you look at the most recent entries. You decide to buff her numbers, you treat the symptom, not the cause of it.. you prescribe a diuretic. Little do you know that her not producing urine is a dangerous complication of her surgery. By 7am her pressure is tanked, she's barely pushing systolic, and she's practically dead. The attending is livid and tries to track you down... oh well, 80 hours of duty call are up... you're at home or at an IHOP eating a short stack. You never really get to see the rotten fruits of your labor.

    I think residencies are demeaning and inhumane only to make you learn as much as possible. Duty hours are a good thing, but they are also a nuisance at the same time.
     

    YouNeverKnow22

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    one of the most famous surgeons ever-William Hasted (1st chief surgeon at Hopkins) was a coke head.


    and I can tell you most surgery residents lie about hours anyway, there isn't a good system in place because if you lower hours you have to employ more people....more hours=more learning
     

    LifeTake2

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    http://www.menshealth.com/health/junkie-or... but do you think med schools should drug test all candidates?

    Yes, absolutely. Most professional jobs, and more than a few manufacturing jobs not only have a drug test pre-employment; many often have random testing once you are hired.

    The question is: should medicine follow the lead of industry or the lead of McDonalds (who doesn't test as they wouldn't have employees)??

    I have been screened before every job I have ever held professionally; random-screened several times; and have terminated employees for testing positive.
     

    CodeBlu

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    Yes, absolutely. Most professional jobs, and more than a few manufacturing jobs not only have a drug test pre-employment; many often have random testing once you are hired.

    The question is: should medicine follow the lead of industry or the lead of McDonalds (who doesn't test as they wouldn't have employees)??

    I have been screened before every job I have ever held professionally; random-screened several times; and have terminated employees for testing positive.

    May I ask what kind of jobs these were? Setting? Level of education etc.?
     

    CodeBlu

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    Odds are that your take on what constitutes a "professional" job is skewed. If you were a secretary, a delivery driver, or some mid-level desk functionary, you had to pee in a cup before they would hire you. When you have an adult job (like physician, attorney, executive, etc) nobody asks you to do that.

    They can do it for med students if they want, but doubt it would fly for the grownups in the long coats.

    Whoa whoa. Mid level? That delivery driver makes sure your food gets to the grocery store... the secretary does all the work you feel you are too entitled to be doing.

    Adult job? So... cuz someone's mother is a secretary... makes them not an adult? Interesting... I think these "adult" doctors, attorneys, executives should be drug tested based on the RESPONSIBILITY they carry.
     

    LifeTake2

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    Odds are that your take on what constitutes a "professional" job is skewed. If you were a secretary, a delivery driver, or some mid-level desk functionary, you had to pee in a cup before they would hire you. When you have an adult job (like physician, attorney, executive, etc) nobody asks you to do that.

    They can do it for med students if they want, but doubt it would fly for the grownups in the long coats.

    I can tell you that companies such as Toyota, Yamaha, GM, etc test ALL employees pre-employment, including executives. It is merely policy and part of life. I personally hold a graduate degree, and senior management position and a 6-figure income for one of the largest manufacturers of fork lifts in the country. And yes, I was tested before I was hired, as was my boss (Director).

    It looks as if while you have 7,000 posts on SDN you don't have much experience in the 'real-world'.
     

    CodeBlu

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    I can tell you that companies such as Toyota, Yamaha, GM, etc test ALL employees pre-employment, including executives. It is merely policy and part of life. I personally hold a graduate degree, and senior management position and a 6-figure income for one of the largest manufacturers of fork lifts in the country. And yes, I was tested before I was hired, as was my boss (Director).

    It looks as if while you have 7,000 posts on SDN you don't have much experience in the 'real-world'.

    This.
     

    CodeBlu

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    Income level doesn't make you a professional, and that MBA from University of Phoenix doesn't either.

    "Professionals" have professional degrees. They do professional jobs. Regardless of your income, you work in a factory. Of course they drug tested you.

    Try to keep up.

    UMichMedAdmiss UMich Med Admissions Twitter.
    Admission tip: Treat all the people in our office nicely-I care about how you treat all people not just the ones who make decisions!
     

    LifeTake2

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    May I ask what kind of jobs these were? Setting? Level of education etc.?

    Example from former company:

    Japanese owned mfg of ATVs. We tested everyone from hourly through senior management pre-employemnet. Only exception I'm aware of is we didn't test the Japanese employees since they worked for Japan not us.

    As for random screening, once a month HR generated a report of employee ID's randomly and walked around and did tests. The database had all active employees. Now we had ~2000 employees and tested a couple of dozen each month so the odds were low but yes we tested everyone.

    In addition, ANY accident (fork lift, golf-car wreck, fell down stairs) required a mandatory test within 4 hours for liability.

    Ultimately different companies have different rules; but industry tends to test. I can't speak for banks, etc but I would expect they would at some level as well.
     

    CodeBlu

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    Not my fault when someone doesn't know what "Professional Degree" is. Yes, it has a specific meaning, not just "I work in a job where I get a salary." So much for real world experience, huh?

    Also, it's been about 8 years since I had to worry about admission committees.

    Clearly they let something slip by them.

    So professionals like pharmacists who deal with drugs, lawyers, dentists shouldn't be drug tested? Those people are professionals too, aren't they? Or are they too low on your ranking scale?
     

    artsciencelove

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    Random drug testing damages the morale of workers. Drug tests should only be for cause when 2 managers agree and document that an employee's behavior merits a drug test. A positive result should mean diversion to a treatment program, not summary termination. Pre-employment drug screening only detects people who are unable to stop taking drugs for 72 hours, or a few weeks in the case of cannabis.

    Drug testing has its place, but it shouldn't be a witchhunt in which everyone is assumed to have a problem unless proven otherwise. Drug addicted people need help, and the goal of attempting to identify them should be to offer them assistance with their problem.

    If employees knew they could not be fired for having a drug problem, and they would be offered medical assistance and counseling if they came forward, I bet a lot of them would. Wouldn't that be better for everyone?
     

    CodeBlu

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    Random drug testing damages the morale of workers. Drug tests should only be for cause when 2 managers agree and document that an employee's behavior merits a drug test. A positive result should mean diversion to a treatment program, not summary termination. Pre-employment drug screening only detects people who are unable to stop taking drugs for 72 hours, or a few weeks in the case of cannabis.

    Drug testing has its place, but it shouldn't be a witchhunt. Drug addicted people need help, and the goal of attempting to identify them should be to offer them assistance with their problem.

    If employees knew they could not be fired for having a drug problem, and they would be offered medical assistance and counseling if they came forward, I bet a lot of them would. Wouldn't that be better for everyone?

    Gonna pull an aSagacious move... source? I expect an industrial psychological study on the topic.

    And risk not being able to smoke their ganja?
     

    LifeTake2

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    Random drug testing damages the morale of workers. Drug tests should only be for cause when 2 managers agree and document that an employee's behavior merits a drug test. A positive result should mean diversion to a treatment program, not summary termination. Pre-employment drug screening only detects people who are unable to stop taking drugs for 72 hours, or a few weeks in the case of cannabis.

    Drug testing has its place, but it shouldn't be a witchhunt. Drug addicted people need help, and the goal of attempting to identify them should be to offer them assistance with their problem.

    If employees knew they could not be fired for having a drug problem, and they would be offered medical assistance and counseling if they came forward, I bet a lot of them would. Wouldn't that be better for everyone?

    Firstly, most pre-employment screening offer's that are withdrawn are due to cannabis. And it stays in your system longer that most realize.

    As for helping, anyone that comes forward with an issue gets free, anonymous help, and won't be fired. Anyone that tests positive is gone. We are grown ups and you have to live with the decisions you make.
     

    LifeTake2

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    You're really going to make me explain what a professional degree is? Internet not working right today?

    No, pharmacists shouldn't be drug tested. Professionals in general shouldn't be drug tested, unless there is a reason. Nor would most of us accept it. Nobody is arguing that when an appropriate licensing or professional organization has a suspicion of illicit use they shouldn't make people pee in a cup, but random testing done without suspicion is not appropriate for people like us.

    Or me I guess, since you haven't made it in the club yet.

    There is your problem, you are no better than anyone else; your delusions of greatness are clouding your posting.
     

    CodeBlu

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    You're really going to make me explain what a professional degree is? Internet not working right today?

    No, pharmacists shouldn't be drug tested. Professionals in general shouldn't be drug tested, unless there is a reason. Nor would most of us accept it. Nobody is arguing that when an appropriate licensing or professional organization has a suspicion of illicit use they shouldn't make people pee in a cup, but random testing done without suspicion is not appropriate for people like us.

    Or me I guess, since you haven't made it in the club yet.

    :laugh:
     
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    235788

    No. :) As long as their recreational activity doesn't effect their work. Should they be tested for steroids and academic doping too?
     

    SitraAchra

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    What are your views on new anesthesia residents getting tested? I'm a newly minted CA-1 and my program had all of us tested. However no one stared at my junk when I did.

    I'd imagine as an attending I'd be put off by it, I guess as a resident I'm still in full-on jump through hoops mode.
     

    CodeBlu

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    What are your views on new anesthesia residents getting tested? I'm a newly minted CA-1 and my program had all of us tested. However no one stared at my junk when I did.

    i'd imagine as an attending I'd be put off by it, I guess as a resident I'm still in full-on jump through hoops mode.

    If it becomes the norm... you won't mind periodic drug tests as an attending?
     
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    235788

    I feel it would be used as a way to further bring shame and distrust towards the medical profession. Why would a physician need to be drug tested? Is it really a problem?
     

    SitraAchra

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    One of the reasons I chose to be a doctor was to be autonomous and self sufficient, trying to minimize the number of people I "answer to". Of course there is always someone to answer to in any profession at any level, but having random drug tests as an attending without some prior suspicion takes away some of that autonomy. I would find that troublesome.

    I'm in agreement with Tired in that as you get further into this career, with the sacrifices you make, you expect to receive a certain amount of respect that comes with so much responsibility.
     
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    235788

    Yes, it is a problem. Especially in anesthesia, where drugs with abuse potential are readily available and relatively easier to divert. There was also an interesting paper a few years ago that measured aerosolized fentanyl near the head of operative patients, and implied that exposure to this potentially increased drug abuse in anesthesiologists.

    That's probably why the previous poster is getting tested as a CA-1. Of course, some of the drugs that are diverted are not readily testable using standard methods, so either they're paying a lot of money for different types of testing or it is being used as a deterrent.

    Google will pull up some good studies for you, last time I looked there were estimates that as many as 10% of practicing anesthesiologists had diverted at one point or another.

    That is very interesting. Are the admissions gates not weeding out effectively? It's disappointing that the few (10% arguably a "few") are damaging the images of the many.
     

    Lil Mick

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    You can't know how someone will react to a situation like medical school/residency until they are actually in that situation where they feel like there aren't enough hours in a day to learn everything for finals or in which they are responsible for a patient dying. Some people will cope with it well; some may start drinking a lot or using drugs to deal with it (even if they had never touched the stuff before).

    On a personal note, I know of students who responsibly drink and/or smoke pot--never incapacitated, never when they may have to see patients. I also know students who didn't drink or do drugs in undergrad who wind up partying quite a bit to do deal with the stress of school or who have taken up prescription drugs to help them study. I'm not sure you'd be able to adequately screen people for the potential to do something dangerous, even if it didn't impinge in personal liberty...
     

    luli

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    Sure alcohol is legal... but no doubt it causes problems. When you have a hungover doc coming in to perform surgery on you... would you want that guy/girl cutting you up? I wouldn't.

    I wasn't arguing for booze in the OR--just pointing out that they can't screen out med students for alcohol abuse. I see alcohol as more of a danger than occasional pot use.
     

    CodeBlu

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    I wasn't arguing for booze in the OR--just pointing out that they can't screen out med students for alcohol abuse. I see alcohol as more of a danger than occasional pot use.

    Occasional pot use is harmless IMO. Alcohol is also a major problem as well.

    But, there should be more resources for doctors who are stressed to no end.
     

    CodeBlu

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    In general, sure. But what worries a lot of us is the fact that a physician, who has so very much to lose, would still choose to commit an illegal act by purchasing and using marijuana.

    The state medical boards are pretty clear on this subject: the use of an illegal drug or the commission of an illegal act is grounds for the suspension or revokation of your license. That means, at least temporarily and maybe permanently, you have no livelihood.

    Someone who is willing to take that risk to get high is someone whose medical practice probably warrants increased scrutiny, and may have other issues they need to address.

    Or... they get a medical marijuana license script from their doctor friends.
     

    CodeBlu

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    Then there's the genetic information that is slowly becoming widespread...

    if someone's genes tell you their mu opioid receptor has an especially high affinity for opioids and the like... should they be doing anesthesiology...since they have a higher risk for addiction?

    http://en.wikipedia.org/wiki/Genetic_Information_Nondiscrimination_Act

    maybe medical schools will fingerprick and do a SNP chip on applicants in the future. it's not too far fetched.
     
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    45408

    That is very interesting. Are the admissions gates not weeding out effectively? It's disappointing that the few (10% arguably a "few") are damaging the images of the many.
    I doubt any of this could be fended off at the level of med school admissions.

    There is your problem, you are no better than anyone else; your delusions of greatness are clouding your posting.
    Your response belies your illusion of understanding. That's not what he said or what he was getting at.
     

    circulus vitios

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    I personally know two doctors, one surgeon one internist, who do ecstasy pretty often. From what they are saying, it is fairly common in the medical field.

    I really doubt it's common and even if it was, ecstasy is pretty safe and not particularly addictive.
     

    CodeBlu

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    circulus vitios

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    Ecstasy is safe? Risk of overheating, dying of cardiac failure?

    Have you seen Bad Boys???

    If you want to talk amphetamines... take adderall or something.

    MESCALINE is less addictive than MDMA...

    http://en.wikipedia.org/wiki/File:Drug_danger_and_dependence.png

    :laugh: What are the units of "drug dependence potential" and how is it quantified?

    Overheating and cardiac failure are symptoms of idiots using ecstasy.

    Mescaline is a psychedelic and completely nonaddictive so that's a useless metric.
     

    CodeBlu

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    45408

    Weird how you can leave here for like a year, and when you come back it's still all the familiar names.
    Yeah....about that...

    Panda Bear is long gone. He's the only one I miss, especially since his blog has been cold and dead for years now.
     

    CodeBlu

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    It's a shame, he really "got it" in ways that I am only now starting to appreciate. If I had more time, I would comb though his posts and compile an anthology. There are just so many lies that are told to us, that we tell to each other, that our academics pass on to the young college students interested in the field...and yet in spite of it all we hold this massive amount of power that we so rarely work up the balls to exercise...

    Ah, I'm getting nostalgic for him now.

    Sorry for the thread hijack.

    Don't apologize. Nostalgia is completely acceptable. Besides we like you old timers around here. You're full of wisdom and all that good stuff.
     

    Bellette

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    I think screening candidates for addiction "risk factors," a la MMI/personality test, might make more sense. And further reducing the demands of residency and everyday practice to a more "human" level. Are either of those feasible? I don't know.

    I won't say that I agree with the idea of testing for personal proclivity toward addiction. My dad's family is a slew of drunks, himself (now retired general surgeon) included. I recognize my own tendencies, whether you want to call them genetic or personality-based, toward substance abuse, but I don't believe I would deserve a red flag next across my application on the basis of candid answers to a personality test.

    As far as adjusting demands upon residents and doctors, that's a wonderful concept. I think it must be fratboy-ish self-congratulation for having suffered through residency, that perpetuates the blatantly safety-prohibitive lack of sleep and personal care. An unnamed department at my school's hospital only just barred residents from working more than 24 hours at a time, because a sleep deprived resident killed the family member of an extremely wealthy local figure (must have been a damning lawsuit to spur such reform). I'm not so sure you have to be all that smart to become a doctor, if doctors don't recognize the dangers of 48-hour shifts. Just imagining it makes me want a drink.
     
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