Revoked license to addictions fellowship.. is this common?

[vistaril]

This one uses the same data but is a more thorough assessment: http://www.journalofsubstanceabusetreatment.com/article/S0740-5472(08)00182-7/abstract?cc=y=

I think the 3 of us (along with Splik) have discussed this issue multiple times on this board... yes, the ~80% abstinence rate is likely an over estimate given the above reasons, and the relapse rate after the 5 year contract is probably enormous (I talked to Lisa Merlo about this a few years ago- data is being collected, but it's all voluntary, self report). However, the ~72% successful return to work with no, major issues is really remarkable, especially when you compare people who complete the contract (91%) to people who don't (28%). Obviously every single participant adhering to PHP guidelines with 100% abstinence would be preferable, but even just constraining use for a 5 year period allows many doctors to be alive and functional, at least while under contract.

I'm not necessarily pro or anti php(although I do think there are serious quality and ethical issues with many of them); I just don't read much into this data either way. Impossible to set up a control group of any value for starters. The 12 week residential model is the 'gold standard' why? If you ask large residential treatment centers that specialize in health professionals they will compare 12 weeks residential treatment at 'approved' facilities to the more varied(often shorter and less restrictive) treatments of nurses and say "well look at the physicians, pharmacists and dentists....it's higher so that speaks to 12 weeks at only these centers being worth it". Ummm no....an oral surgeon who goes to a 12 week residential facility at talbot is going to have a better outcome in terms of 1, 2,3,5 year relapse than a nurse who did 4 weeks residential at a 'lesser' facility and 4 weeks IOP because the oral surgeon has a 600k a year career to protect and the nurse has a 65k a year career to protect. I'm not saying the current standard is too much, too little, too whatever....just that the data and justification I've seen for it is flimsy and not well done. Also having worked in this field before the knowledge base of some of the people administering these programs regarding the limitations of testing in certain instances is shocking....one 'addictionologist'(whatever that means) from a western state was only off by about 70 or 80 hours on how long a typical person would test positive for hydrocodone after being given a 20mg single dose or one of the testable metabolites in urine with the most used cutoff. This is something a typical high school kid could look up online if they are trying to beat their parents drug tests they send out for christ sakes....

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