Will Counseling for Suicidal Thoughts and Alcohol Abuse (+ Ambien) Ruin my Career?

[pianopeep]

tl;dr - If I tell a counselor/psychiatrist/psychologist that I have suicidal thoughts and I abuse alcohol (and often take Ambien with it), will they notify my state board or my employer that I am unfit to work?

I'm having trouble with life right now and I need to talk to a professional. I frequently think of killing myself and I drink about 3-5 glasses of wine every night along with ambien. On the weekends, I'm in my bed drinking by noon about to go on a bender. My biggest fear is that the professionals may contact my state board and/or employer to temporarily suspend my license until this gets sort out. This is a catch 22. How can I pay for a professional if I have no job!? Plus, I'd rather die than not be a pharmacist. This is really the only thing going for me in life. Everything else has pretty much gone to hell.

Side note, my professional work is pristine. I'm one of the hardest working pharmacists in my hospital, my error rate is one of the lowest, my annual evaluation score was one of the highest (we coworkers compare notes), I'm involved in several projects, and trainees often request me to be their trainer. Basically, my professional life is not slacking off.

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[boriqua]

tl;dr - If I tell a counselor/psychiatrist/psychologist that I have suicidal thoughts and I abuse alcohol (and often take Ambien with it), will they notify my state board or my employer that I am unfit to work?

I'm having trouble with life right now and I need to talk to a professional. I frequently think of killing myself and I drink about 3-5 glasses of wine every night along with ambien. On the weekends, I'm in my bed drinking by noon about to go on a bender. My biggest fear is that the professionals may contact my state board and/or employer to temporarily suspend my license until this gets sort out. This is a catch 22. How can I pay for a professional if I have no job!? Plus, I'd rather die than not be a pharmacist. This is really the only thing going for me in life. Everything else has pretty much gone to hell.

Side note, my professional work is pristine. I'm one of the hardest working pharmacists in my hospital, my error rate is one of the lowest, my annual evaluation score was one of the highest (we coworkers compare notes), I'm involved in several projects, and trainees often request me to be their trainer. Basically, my professional life is not slacking off.

i have no clue cause i'm not a psychiatrist. but even with basic understanding of the field, i know that they are bound by confidentiality to keep anything you say to them between you 2. if they break the confidentiality, you can notify their state board or employer that they are unfit to work.

 

[desidoc_]

I'm fairly sure the only time a medical health professional can break confidentiality is if they have any reason to suspect that either you or others are in immediate danger. For example, if you were to use alcohol x ambien and then go out for a drive or if you actively ideate and have a suicide plan and can foreseeably follow through with it.

 

[desidoc_]

If you're still not sure I would call a suicide hotline and you can ask them. I'm sure they would know. It might not seem like it but your mental health is always more important than a job or any career aspirations you may have. If you're not here then you won't ever get to achieve your goals.

If you need someone to talk to I'm here. I don't abuse alcohol but I do have depression and passive suicidal ideation. Don't hesitate to reach out

 

[boriqua]

also, using the logical standpoint, what benefit would a psychiatrist gain from one of their patients losing their job? that would be like calling the cops on all your best customers after you sell them crack

 

[trailerpark]

Why can't you just lie about your job to the psychiatrist?


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[RPh Who]

I'm fairly sure the only time a medical health professional can break confidentiality is if they have any reason to suspect that either you or others are in immediate danger.

So abusing ambien and alcohol and going on weekend benders then going to work doesn't endanger patients? The work can be pristine, up until the day someone gets hurt. Good performance at work despite substance abuse doesn't justify the behavior

 

[desidoc_]

So abusing ambien and alcohol and going on weekend benders then going to work doesn't endanger patients? The work can be pristine, up until the day someone gets hurt. Good performance at work despite substance abuse doesn't justify the behavior

Of course. I agree completely. I think it's important to note though that abusing ambien and alcohol =/= going on weekend benders. I can't say for @pianopeep specifically nor should they feel pressured to disclose details of their mental health but given the context and my own experiences, substances are often used to numb the pain. To make life survivable. There's a huge difference between using illicit drugs and going to a rave to black out and get **** faced with your friends, and feeling so much f*cking pain that living is unbearable and consuming alcohol to numb the pain, to stop your brain from running a mile a minute and thinking about all the things that are wrong with you as a human being and why you don't deserve to live. Of course, objectively speaking, doing your job well doesn't excuse abusing substances. But I think compassion and empathy are important. This isn't the same as making your bed to lie in it. Suffering from poor mental health doesn't excuse objectively "bad"/destructive behaviour but it sure does make it a hell of a lot more understandable. And I'm sure OP doesn't consume alcohol x ambien in the morning just before going to work. But yes, getting help is necessary and the most important for oneself and, by extension, one's patients.

 

[boriqua]

So abusing ambien and alcohol and going on weekend benders then going to work doesn't endanger patients? The work can be pristine, up until the day someone gets hurt. Good performance at work despite substance abuse doesn't justify the behavior

of course it can potentially endanger patients but i'm not sure if it would rise to the level of breaking confidentiality. If you are saying that you are planning to kill ____ person and saying exactly how and when you are going to do it, the psychiatrist would probably then be compelled to break confidentiality. saying that you take a couple of ambiens and a shot or 2 before you go to sleep puts zero people in immediate danger and thus a psychiatrist wouldn't be able to break the confidentiality

 

[beautifulrobot]

Why can't you just lie about your job to the psychiatrist?


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I imagine one's profession and associated stressors plays a big role in therapy, as well as being honest with yourself and others. Lying probably isn't the best solution.

 

[RPh Who]

Of course, objectively speaking, doing your job well doesn't excuse abusing substances. But I think compassion and empathy are important. This isn't the same as making your bed to lie in it. Suffering from poor mental health doesn't excuse objectively "bad"/destructive behaviour but it sure does make it a hell of a lot more understandable. And I'm sure OP doesn't consume alcohol x ambien in the morning just before going to work. But yes, getting help is necessary and the most important for oneself and, by extension, one's patients.

I think 3-5 glasses per night plus the weekend bender starting at noon could reasonably be construed as chemical dependence. Here are two questions from a pharmacist renewal application:

Do you have a medical condition which in any way impairs or limits your ability to practice pharmacy with reasonable skill and safety? If yes, please explain.  

11. Does your use of chemical substance(s) in any way impair or limit your ability to practice pharmacy with reasonable skill and safety? If yes, please explain.

My intent is not to chastise OP, simply to address an issue of integrity. Should OP get help? Yes, obviously. I am not addressing the concept of breaking confidentiality, rather an issue of being honest. Attempting to deceive the board on an application can have pretty serious consequences. Usually there are professional recovery programs available for chemical dependency/mental health issues. There has to be a balance to getting help and being a potential risk to the wellbeing of others.

 

[ldiot]

You may be a high-functioning alcoholic, not just someone who abuses alcohol. I think someone who truly cared about your well-being would advise you to seek professional counsel regardless of if the state board would find out. You should do this for your own health

I'm not sure if they can release this information to the state board, and even if they do I'm not sure that the state board would even do anything so long as you haven't been to work under the influence or gotten a DUI. The Ambien may be an issue if it was not prescribed but I assume that it has been.

 

[El Trombopag]

I'd be also concerned about the inevitable time you do mess up, or get lumped in with someone else's mistake. Damage control people, lawyers, etc. will look for things like this to blame when things go wrong. A few years ago we had a pharmacist who made several labelling errors...single signing, several wrong meds actually made it to patients. There was discussion about 'drug testing the whole department' by angry docs and administrators. It all blew over eventually, but sure reinforced the view that at most hospitals pharmacy is viewed as a unit, not as variably competent individuals. I personally think that as pharmacists we need to be cleaner than most with regard to substances...might be worth checking your state board/commission. Many have anonymous ways of helping. Regardless, alcohol will catch up with you eventually, it will never be easier to start addressing the problem than today.


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[ChalupaBatman86]

So many stupid and insensitive comments here. You need to get help and stop drinking. As long as you do that BEFORE you get in trouble for something else you will not endanger your license. Don't tell the board, just get the help you need. Don't apply for new licenses right now, you might have to lie. Just the fact you recognize there is a problem and you are seeking help tells me you will be fine.

 

[ldiot]

So many stupid and insensitive comments here. You need to get help and stop drinking. As long as you do that BEFORE you get in trouble for something else you will not endanger your license. Don't tell the board, just get the help you need. Don't apply for new licenses right now, you might have to lie. Just the fact you recognize there is a problem and you are seeking help tells me you will be fine.

I agree 100%, though I don't think many (if any) of the previous comments were insensitive.

 

[KARM12]

Please get the help you need. Most boards or jobs have a clause for patients who are attempting to get treatment for chemical dependence issue in that you will not be faulted if you are seeking help.

If you are in need of immediate help, please call the suicide hotline or seek other professional help. Don't wait. The first step is admitting you need help and you have done that.

 

[BidingMyTime]

I'm pretty sure psychologists/psychiatrists as mandated reporters, would legally be required to report you *if* they thought you were a danger to patients. Are you a danger to patients? No one here can know that, that would be something your doctor would have to decide. Still, as others have pointed out, most boards (maybe all of them) will be supportive of a technician or pharmacist who is getting help. I think its far more likely that you would be in serious trouble with the board down the road, if you don't see help, then your being in trouble with the board for seeking help. Obviously if you end your life, your career wouldn't matter at that point, so you really should seek help before it gets to that point. You have everything to gain by seeking help.

 

[PikminOC]

It's not about wanting you to keep your job so you can keep paying us. It's about safety, just like you guys are on the hook for a prescription.

This came up recently in the German wings case where the pilot had seen doctors prior to killing passengers..

 

[PikminOC]

i have no clue cause i'm not a psychiatrist. but even with basic understanding of the field, i know that they are bound by confidentiality to keep anything you say to them between you 2. if they break the confidentiality, you can notify their state board or employer that they are unfit to work.

This makes no sense. You can complain to the board they violated your confidentiality and sign so the board can get your records. They will look into the documentation to make a decision and see if it was appropriate or not.