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Decided to start this thread because no anesthesia forum is complete unless this subject is talked about. OK, so gotta story to tell? -Zippy
Substance abuse in Anesthesia
- Thread starter zippy2u
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I think that this is a very serious topic. For those that have problems and for those that know people with issues in this area, it is not something that needs to be "gossiped" about on this forum because you think that it would make for an "interresting" thread.
But then again... that is just my opinion
But then again... that is just my opinion
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Substance abuse in anesthesia is a serious issue that needs to be talked about.
The issue is access. Internal medicine residents order morphine on a paper sheet and it is "magically" given to the patient by the nurse, much like your mom used to do your laundry. In the OR, an anesthesiologist who wants to give morphine has to reach into the narc box, draw it up and then push it - huge difference in access.
I think substance abuse is a disease, much like diabetes or hypertension - some people have it, some don't. Some people are just predisposed to abusing alcohol, caffeine, tobacco, etc. People who have this kind of self-awareness and insight should probably look to another career besides anesthesia. A classmate of mine clearly stated that he would never go into anesthesia precisely because of these concerns and I think that was very wise.
Then the other issue is "experimentation". Some people aren't necessarily substance abusers, but have a curiosity as to what something is like. At one of the places I rotated, one resident told me that the attendings sat them down at the start of their residency and said "yes, fenanyl IS that good. don't try it".
Some people (i.e. "experimenters") may be able to come back to anesthesia after rehabilitation. Other people (i.e. "predisposed abusers") may not. Regardless, substance abuse is an occupational hazard much like needle sticks.
The issue is access. Internal medicine residents order morphine on a paper sheet and it is "magically" given to the patient by the nurse, much like your mom used to do your laundry. In the OR, an anesthesiologist who wants to give morphine has to reach into the narc box, draw it up and then push it - huge difference in access.
I think substance abuse is a disease, much like diabetes or hypertension - some people have it, some don't. Some people are just predisposed to abusing alcohol, caffeine, tobacco, etc. People who have this kind of self-awareness and insight should probably look to another career besides anesthesia. A classmate of mine clearly stated that he would never go into anesthesia precisely because of these concerns and I think that was very wise.
Then the other issue is "experimentation". Some people aren't necessarily substance abusers, but have a curiosity as to what something is like. At one of the places I rotated, one resident told me that the attendings sat them down at the start of their residency and said "yes, fenanyl IS that good. don't try it".
Some people (i.e. "experimenters") may be able to come back to anesthesia after rehabilitation. Other people (i.e. "predisposed abusers") may not. Regardless, substance abuse is an occupational hazard much like needle sticks.
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On my anesthesiology rotation, I was absolutely shocked at how easy it would be to take medicine home. Absolutely shocked. I used to think that all the hype about anesthesia abuse was "hype," but it would be a real issue if someone has an addiction or an addictive propensity.gaspasser2004 said:
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This topic is indeed a serious issue. I don't remember the exact stats, but something around 3-6% (again don't quote me on this) of residents will have a problem w/ substance abuse. At MGH during info session, Dr. Zapol brought it up and MGH does (?random?) urine drug screen when you come in and at least on a yearly basis (again don't quote me on the time period). He does this b/c he takes the problem seriously. Zapol also mentioned other institutions (like Cleveland Clinic) have contacted him as to how to proceed to implement their own testing program...
