In Recovery-Any chance of finishing last 8 months in another state?

[persey100]

I am PGY-4 in a top 4 program (only have 8 months left) and have just finished an extensive stint in rehab, but was not approved to go back to anesthesia. I am told that the state I practice in is notorious for being tough on anesthesia residents. I fully believe I can go back. Anyone have any thoughts on trying to relocate to finish in a more compassionate state? I've heard from CA docs that if my situation had occurred there, I'd already be back to my program. I'm willing to go anywhere.

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[Noyac]

I am PGY-4 in a top 4 program (only have 8 months left) and have just finished an extensive stint in rehab, but was not approved to go back to anesthesia. I am told that the state I practice in is notorious for being tough on anesthesia residents. I fully believe I can go back. Anyone have any thoughts on trying to relocate to finish in a more compassionate state? I've heard from CA docs that if my situation had occurred there, I'd already be back to my program. I'm willing to go anywhere.

Dude, you are not ready to go back!

This is no game. This is your life.

Pick another residency and start over. Preferably one that has no contact with controlled substances. You are young and very early in your career. You can overcome this setback easily but don't stay in anesthesia. Your state is doing you a very big favor and possibly saving your life. Trust me, I was on a substance abuse committee as a resident. We researched the relapse rate of anesthesiologist after returning to work. Those that returned to the OR in less than 1 yr had an amazingly (mindblowing) high rate of relapse. Those that were out for greater than one year still had a very high relapse rate but was much less likely to relapse. With that being said, you are never out of the woods. A good friend of mine had been clean for 12 yrs when he relapsed. He now practices psychology.

I have had many friends in anesthesia who thought they could experiment with the substances and lost. One just died last month. Sure there are people out there that are clean and practicing in the field but why risk it? It truely is life or death.

Try psych, rads, pediatrics, FP or even surgery but get out of anesthesia.

PM me if you have questions. I'll even give you my phone number to talk about this more.

 

[Coastie]

Let this be a lesson to all not to blow your chances at life. Dude, you had everything going for you, and now you do this?

I agree with Noyac. Practice another branch of medicine. It's not worth it...

I am PGY-4 in a top 4 program (only have 8 months left) and have just finished an extensive stint in rehab, but was not approved to go back to anesthesia. I am told that the state I practice in is notorious for being tough on anesthesia residents. I fully believe I can go back. Anyone have any thoughts on trying to relocate to finish in a more compassionate state? I've heard from CA docs that if my situation had occurred there, I'd already be back to my program. I'm willing to go anywhere.

 

[goodoc]

Do not go back, the temptation to use will be overpowering. You must respect the medications we give every day cause they aand biology are far more powerful then our "willpower". Take the above mentioned advice, it could save your life.

 

[Gern Blansten]

I will chime in here to agree with all of the other posters. It would be a huge mistake for you to continue in anesthesiology. A mistake that could cost you or your patients dearly. Don't do it. Make a clean break. It is easy to think you have this thing beat. History tells us that you would be wrong almost all of the time, and a far too common way that others figure out you were wrong is to find the relapsed physician dead. Vegas would never bet those odds and neither should you.

 

[Noyac]

I'm afraid we may have chased persey away. I just hope he/she takes our advice.

 

[MAC10]

........

 

[bubalus]

I understand how you want to finish what you've come so close to finishing. However, the recidivism rate is enormously high for those who have a problem in residency and return to anesthesia residency--higher than for those who are in practice and return to practice. Most programs will not allow you back, and they do that to save your life. A significant number of those who relapse present by dying. I've known more than one anesthesiologist and anesthesia resident with substance abuse problems. Those that survived are the lucky ones. I commend you for going to rehab and making it through, and I commend you for your desire to return to medicine, but for your own sake, please pick another field. I say that not because I necessarily consider you a liability to the field, but rather because you stand a very good chance of dying should you return to anesthesia.

 

[Gasworks]

Did you hire an attorney during this process? Is there an appeals process? Was this a state decision or your program? Your best shot is getting back into your own program. You are gonna have to make on helluva tough sell to convince a program that knows nothing about you to take the risk. If you had any slip ups in the rehab process or if they consider you at high risk to repeat then forget it. Alot of these state run rehab boards are not staffed by docs.. just state employees who really dont think you should catch any breaks.

I talked to my PD about this once and he mad it very simple.. he said that the first time they catch you its because you got sloppy but the second time they catch you its usually because you're dead.

 

[TX515]

What did you go to rehab for?

 

[Noyac]

What did you go to rehab for?

Bagels laced with cream cheese.

 

[TX515]

Or alcohol, cannabis...

 

[Strength&Speed]

Ok dudes....again found this post on a post search. curious...why do so many people die do you think....since you know the proper dosages for medications....do people just go overboard?

also, how do you START using morphine drugs on anesthesia....oral pills or do people go straight to injecting?

 

[bubalus]

Dosages vary, especially with opioid experience. But I imagine that we've all given a spontaneously ventilating patient a little too much and watched them go apneic. Unfortunately if you do that to yourself, there's no one around to ventilate you. It also depends on the drug of abuse. Propofol is becoming more abused, and again, you miscalculate, and instead of a buzz dose, you get an induction dose.

 

[InductionAgent]

Ok dudes....again found this post on a post search. curious...why do so many people die do you think....since you know the proper dosages for medications....do people just go overboard?

also, how do you START using morphine drugs on anesthesia....oral pills or do people go straight to injecting?

There's all sorts of individual variances on how people get into narc abuse. The biggest factor though is access. What do OR anesthesiologists have access to? IV narcs, not pills. So I've heard several stories of people starting their narcotic abuse with IV from the beginning. For pain docs with access to their patients' narcs via pill counts, etc, PO abuse can be more common.

 

[Strength&Speed]

There's all sorts of individual variances on how people get into narc abuse. The biggest factor though is access. What do OR anesthesiologists have access to? IV narcs, not pills. So I've heard several stories of people starting their narcotic abuse with IV from the beginning. For pain docs with access to their patients' narcs via pill counts, etc, PO abuse can be more common.

great. thanks induction, very helpful. I have always found it intriguing how very dedicated, intelligent, and well meaning people can get hooked on such drugs. It speaks to their incredible addictive potential.

 

[nap$ter]

it is a bit baffling to think that a highly trained clinical pharmacologist/physiologist could a)experiment with such highly addictive substances, and b)overdose.

my theory is that when an anesthesiologist takes the first dose and down the road ends up overdosing, they are not thinking with their scientific clinician brain. they are thinking with their addict lizard brain, which is not logical or reasonable, and doesn't consider apneic thresholds, risk of death, or dose response curves, etc...

 

[Strength&Speed]

it is a bit baffling to think that a highly trained clinical pharmacologist/physiologist could a)experiment with such highly addictive substances, and b)overdose.

my theory is that when an anesthesiologist takes the first dose and down the road ends up overdosing, they are not thinking with their scientific clinician brain. they are thinking with their addict lizard brain, which is not logical or reasonable, and doesn't consider apneic thresholds, risk of death, or dose response curves, etc...

Yeah, I know....it's just that I find it hard to believe people would go 'straight to injecting'. I mean, everyone knows that's going to be problems. I can understand pills when you had a bad day or some back pain...or maybe a fentanyl sucker for fun. But injecting? Wow. What's going on there?

 

[nap$ter]

i think most don't go straight to injecting; they spiral downwards over time. addiction is a chronic progressive disease. they flirt with disaster with alcohol, weed, etc, yeah, maybe some vicodin for back pain, and eventually slip a needle in their vein. again, not thinking with their clinician brain.

 

[njac]

and many of the injectable forms of these drugs are also (somewhat) active PO. I'm pretty sure you could get something out of some fentanyl rubbed on your gums, or the old intranasal versed. The morphine in the tubex might not taste as good as the elixir but it's the same stuff.