Impaired Professionals

Substance Use Disorders among Helping Professionals

Collectively, substance use disorders (SUDs) are the most prevalent behavioral health problem in the United States. It is estimated that approximately 810,000 individuals are dependent on opioids, 2.5 million individuals are addicted to cocaine, and approximately 3 million people are thought to be addicted to marijuana. Alcohol, however, is the substance involved in the preponderance of the drug abuse and addiction problems in this country. Of the estimated 119 million Americans who use alcohol, 16.27 million are thought to be physically dependent on it. Consequently, it is estimated that alcoholism alone accounts for 85% of the drug addiction in the United States.

Contrary to stereotypical notions of addicts, such as drunks on skid row and drug users in jail, the majority of addicts are employed. It is estimated that fully 76% of illicit drug abusers in the United States are employed, as are 81% of the binge drinkers and 81% of the heavy drinkers. In light of these numbers, it therefore should come as little surprise that some of whom Robert Coombs calls "pedestal professionals"—physicians and other health care professionals, airline pilots, and attorneys—are also members of the addicted population.

Despite high levels of education and specialized training, professionals are not exempt from developing alcohol and other drug dependencies. In fact, [Page 479]research suggests that these widely admired professionals, especially health care professionals, are particularly vulnerable to drug abuse. Douglas Talbott, founder of the Talbott-Marsh Recovery Center in Atlanta, Georgia, has suggested that drug addiction can be a common occupational hazard of health care professionals.

Research has recently focused on examining potential SUD issues among health care professionals. In a survey of nearly 4,500 nursing professionals, 32% reported that they used alcohol, cocaine, prescription drugs, or marijuana on a regular basis. Among those surveyed, emergency room nurses were 3.5 times more likely to use cocaine or marijuana, and oncology nurses were more than twice as likely to binge drink. Interestingly, nicotine use was nearly 3 times more prevalent among psychiatric nurses. Among physicians, it has been estimated that 8% to 12% will develop a SUD and that emergency room physicians and anesthesiologists are most at risk. Counselors and psychologists—those generally on the frontline of SUD treatment—also have an elevated prevalence of SUDs. It has been estimated that around 10% of psychologists report current drinking problems. Another study of counseling psychologists indicated that approximately 6% used marijuana, 7% used tranquil-izers, 1% used stimulants, and 3% used opioids at least occasionally. The most influential risk factor for developing SUDs among all of the professionals just described was job-related stress.

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