114
Views
12
CrossRef citations to date
0
Altmetric
REVIEW

Prescription Opioid Abuse and Dependence Among Physicians: Hypotheses and Treatment

, PhD & , MD
Pages 181-194 | Received 02 Apr 2007, Accepted 10 Oct 2007, Published online: 03 Jul 2009

REFERENCES

  • Torre D M, Wang N Y, Meoni L A, Young J H, Klag M J, Ford D E. Suicide compared to other causes of mortality in physicians. Suicide Life Threat Behav 2005; 35: 146–53
  • Ullman D, Phillips R L, Beeson L, et al. Cause-specific mortality among physicians with differing life-styles. JAMA 1991; 265: 2352–9
  • Sankoff J S, Hockenberry S, Simon L J, Jones R L. Mortality of young physicians in the United States, 1980–1988. Acad Med 1995; 70: 242–4
  • Frank E, Biola H, Burnett C A. Mortality rates and causes among US physicians. Am J Prev Med 2000; 19: 155–9
  • Wells K B, Lewis C E, Leake B, Ware J E. Do physicians preach what they practice?. JAMA 1984; 252: 2846–8
  • Gault R, Yeater R S, Ullrich I H. West Virginia physicians: cardiovascular risk factors, lifestyle and prescribing habits. W V Med J 1994; 90: 364–6
  • Frank E, Schelbert K B, Elon L. Exercise counseling and personal habits of US women physicians. J Am Med Womens Assoc 2003; 58: 178–84
  • Frank E, Brogan D J, Mokdad A H, et al. Health behaviors of women physicians vs other women in the United States. Arch Intern Med 1998; 158: 342–8
  • John U, Hanke M. Tobacco smoking prevalence among physicians and nurses in countries with different tobacco-control activities. Eur J Cancer Prev 2003; 12: 235–7
  • Cigarette smoking among adults—United States. MMWR Morb Mortal Wkly Rep 2005; 54: 1121–4, 2004
  • Weinger M B, Ancoli-Israel S. Sleep deprivation and clinical performance. JAMA 2002; 287: 955–7
  • Defoe D M, Power M L, Holzman G B, Carpentieri A, Schulkin J. Long hours and little sleep: work schedules of residents in obstetrics and gynecology. Obstet Gynecol 2001; 97: 1015–8
  • Williamson A M, Feyer A M. Moderate sleep deprivation produces impairments in cognitive and motor performance equivalent to legally prescribed levels of alcohol intoxication. Occup Environ Med 2000; 57: 649–55
  • Gautam M, MacDonald R. Helping physicians cope with their own chronic illnesses. West J Med 2001; 175: 336–8
  • McKevitt C, Morgan M, Dundas R, Holland W W. Sickness absence and ‘working through’ illness: comparison of two professional groups. J Public Health Med 1997; 19: 295–300
  • Talbott G, Wright C. Chemical dependency in healthcare professionals. Occup Med 1987; 2: 581–91
  • McAuliffe W E, Rohman M, Breer P, Wyshak G, Santangelo S, Magnuson E. Alcohol use and abuse in random samples of physicians and medical students. Am J Public Health 1991; 81: 177–82
  • Krakowski A. Stress and the practice of medicine: physicians compared with lawyers. Psychother Psychosom 1984; 42: 143–51
  • O'Connor P G, Spickard A. Physician impairment by substance abuse. Med Clin North Am 1997; 81: 1037–52
  • Hughes P H, Brandenburg N, Baldwin D C, et al. Prevalence of substance use among US physicians. JAMA 1992; 267: 2333–9
  • Kuehn B M. Opioid prescriptions soar: increase in legitimate use as well as abuse. JAMA 2007; 297: 249–51
  • Manchikanti L. National drug control policy and prescription drug abuse: facts and fallacies. Pain Phys 2007; 10: 399–424
  • SAMHSA. The NSDUH Report: patterns and trends in nonmedical prescription pain reliever use: 2002–2005. Office of Applied Studies, Rockville, MD 2007
  • Baldisseri M R. Impaired healthcare professional. Crit Care Med 2007; 35: S106–16
  • Farber N J, Gilibert S G, Aboff B M, Collier V U, Weiner J, Boyer E G. Physicians' willingness to report impaired colleagues. Soc Sci Med 2005; 61: 1772–5
  • Magnavita N. Management of impaired physicians in Europe. Med Lav 2006; 97: 762–73
  • Dhai A, Szabo C P, McQuoid-Mason D J. The impaired practitioner: scope of the problem and ethical challenges. S Afr Med J 2006; 96: 1069–72
  • Graham C. Poland wrestles with the problem of drunken doctors. Lancet 2006; 368: 190–1
  • Taub S. Physician health and wellness. Occup Med 2006; 56: 77–82
  • Shanafelt T D, Sloan J A, Habermann T M. The well-being of physicians. Am J Med 2003; 114: 513–9
  • Firth-Cozens J, Greenhalgh J. Doctors' perceptions of the links between stress and lowered clinical care. Soc Sci Med 1997; 44: 1017–22
  • Shanafelt T D, Bradley K A, Wipf J E, Back A L. Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med 2002; 136: 358–67
  • American Medical Association Database PF, At http://www.ama-assn.org/apps/pf_new/pf_online/ H-95.955 Substance abuse among physicians
  • American Medical Association Council on Mental Health. The sick physician: impairment by psychiatric disorders, including alcoholism and drug dependence. JAMA 1973; 223: 684–7
  • Harris S. Alcoholism and drug addiction among physicians of Alabama. Transcripts Med Assoc Ala 1914; 685: 91
  • Paget J. What becomes of medical students? St Bartholomew's Hosp. Rep 1869; 5: 238–42
  • Wenstone R. Nitrous oxide. Anaesthesia 1998; 53: 611
  • Adams A K. The delayed arrival: from Davy (1800) to Morton (1846). J R Soc Med 1996; 89: 96P–100P
  • Smith G B, Hirsch N P. Gardner Quincy Colton: pioneer physician in anesthesia. Anesth Analg 1991; 72: 382–91
  • Defalque R J, Wright A J. The short, tragic life of Robert M. Glover Anaesthesia 2004; 59: 394–400
  • Hammonds W D, Steinhaus J E, Crawford W. Long: pioneer physician in anesthesia. J Clin Anesth 1993; 5: 163–7
  • Kavanagh M F. The origin of the word “anesthesia.”. Calif West Med 1928; 29: 10–2
  • Calatayud J, Gonzalez A. History of the development and evolution of local anesthesia since the coca leaf. Anesthesiology 2003; 98: 1503–8
  • Pilcher J E. Ann Surg 1886; 3: 51–66
  • Gold M S, Byars J A, Frost-Pineda K. Occupational exposure and addictions for physicians: case studies and theoretical implications. Psychiatr Clin North Am 2004; 27: 745–53
  • Keys T E. Historical vignettes: Dr. Horace Wells (1815–1848). Anesth Analg 1972; 51: 684
  • Warner S L. Sigmund Freud and money. J Am Acad Psychoanal 1989; 17: 609–22
  • Mandel I D. Colk Koller: mankind's greatest benefactor? The story of local anesthesia. J Dent Res 1998; 77: 535–8
  • Markel H. The accidental addict. N Engl J Med 2005; 10: 966–8
  • Kenna G A, Wood M D. Alcohol use by healthcare professionals. Drug Alcohol Depend 2004; 75: 107–16
  • Hughes P H, Storr C, Baldwin D C, Jr, Williams K M, Conard S, Sheehan D. Patterns of substance use in the medical profession. Md Med J 1992; 41: 311–4
  • Gallegos K V, Browne C H, Veit F W, Talbott G D. Addiction in anesthesiologists: drug access and patterns of substance abuse. QRB Qual Rev Bull 1988; 14: 116–22
  • Gold M S, Melker R J, Dennis D M, et al. Fentanyl abuse and dependence: further evidence for second hand exposure hypothesis. J Addict Dis 2006; 25: 15–21
  • Follette J W, Farley W J. Anesthesiologist addicted to propofol. Anesthesiology 1992; 77: 817–8
  • Iwersen-Bergmann S, Rosner P, Kuhnau H C, Junge M, Schmoldt A. Death after excessive propofol abuse. Int J Legal Med 2001; 114: 248–51
  • Pomm R M, Harmon L. Evaluation and posttreatment of the impaired physician. Psychiatr Ann 2004; 34: 786–9
  • Nace E P, Davis C, Hunter J. A comparison of male and female physicians treated for substance use and psychiatric disorders. Am J Addict 1995; 4: 156–62
  • Schernhammer E, Colditz G A. Suicide rates among physicians: a quantitative and gender assessment (meta-analysis). Am J Psychiatry 2004; 161: 2295–302
  • Roy A. Suicide in doctors. Psychiatr Clin North Am 1985; 8: 377–87
  • Simon W. Suicide among physicians: prevention and postvention. Crisis 1986; 7: 1–13
  • Schernhammer E. Taking their own lives: the high rate of physician suicide. N Engl J Med 2005; 352: 2473–6
  • Alexander B H, Checkoway H, Nagahama S I, Domino K B. Cause-specific mortality risks of anesthesiologists. Anesthesiology 2000; 93: 922–30
  • Lew E A. Mortality experience among anesthesiologists, 1954–1976. Anesthesiology 1979; 51: 195–9
  • Collins G B, McAllister M S, Jensen M, Gooden T A. Chemical dependency treatment outcomes of residents in anesthesiology: results of a survey. Anesth Analg 2005; 101: 1457–62
  • Talbott G, Gallegos K V, Wilson P O, Porter T. The Medical Association of Georgia's impaired physician's program: review of the first 1000 physicians—analysis of specialty. JAMA 1987; 257: 2927–30
  • Gallegos K V, Lubin B H, Bowers C, et al. Relapse and recovery: five to ten year follow-up study of chemically-dependent physicians. The Georgia experience. Md Med J 1992; 41: 315–9
  • McAuliffe P F, Gold M S, Bajpai L, et al. Second-hand exposure to aerosolized intravenous anesthetics propofol and fentanyl may cause sensitization and subsequent opiate addiction among anesthesiologists and surgeons. Med Hypotheses 2006; 66: 874–82
  • Menk E J, Baumgarten R K, Kingsley C P, Culling R D, Middaugh R. Success of reentry into anesthesiology training programs by residents with a history of substance abuse. JAMA 1990; 263: 3060–2
  • Lutsky I, Hopwood M, Abram S E, Cerletty J M, Hoffman R G, Kampine J P. Use of psychoactive substances in three medical specialties: anaesthesia, medicine, and surgery. Can J Anaesth 1994; 41: 561–7
  • Domino K B, Hornbein T F, Polissar N L, et al. Risk factors for relapse in health care professionals with substance use disorders. JAMA 2005; 293: 1453–60
  • Fletcher C E, Ronis D L. Satisfaction of impaired health care professionals with mandatory treatment and monitoring. J Addict Dis 2005; 24: 61–75
  • Storr C L, Trinkoff A, Hughes P H. Similarities of substance use between medical and nursing specialties. Subst Use Misuse 2000; 35: 1443–69
  • Mensch B, Kanel D. Do job conditions influence the use of drugs?. J Soc Behav 1988; 29: 169–84
  • Bissell L, Jones R W. The alcoholic physician: a survey. Am J Psychiatry 1976; 133: 1142–6
  • Boisaubin E V, Levine R E. Identifying and assisting the impaired physician. Am J Med Sci 2001; 322: 31–6
  • Baldwin D C, Hughes P H, Conrad S E, et al. Substance abuse among senior medical students: a survey of 23 medical schools. JAMA 1991; 265: 2074–8
  • Conrad S E, Hughes P H, Baldwin D C, et al. Substance use by fourth-year students at 13 U.S. medical schools. J Med Educ 1988; 63: 747–58
  • Flaherty J A, Richman J A. Substance use and addiction among medical students, residents, and physicians. Psychiatr Clin North Am 1993; 16: 189–97
  • McAuliffe W, Rohman M, Fishman P, et al. Psychoactive drug use by young and future physicians. J Health Soc Behav 1984; 25: 34–54
  • Mansky P. Issues in the recovery of physicians from addictive illnesses. Psychiatr Q 1999; 70: 107–22
  • Reimer C, Jurkat H, Maeculen B, Stetter F. Quality of life and health behavior of physicians with and without substance abuse. Psychotherapeut 2001; 46: 376–85
  • Richman J A. Occupational stress, psychological vulnerability, and alcohol-related problems over time in future physicians. Alcohol Clin Exper Res 1992; 16: 166–71
  • Frank E, Brogan D J, Schiffman M. Prevalence and correlates of harassment among US women physicians. Arch Intern Med 1998; 158: 352–8
  • Jex S M, Hughes P H, Storr C L, et al. Relations among stressors, strains, and substance use among resident physicians. Int J Addict 1992; 27: 979–94
  • Kleber H D. The impaired physician: changes from the traditional view. J Subst Abuse Treat 1984; 1: 137–40
  • Lloyd G. One hundred alcoholic doctors: a 21-year follow-up. Alcohol Alcohol 2002; 37: 370–4
  • Hughes P H, Storr C L, Brandenburg N, Baldwin D C, Anthony J C, Sheehan D V. Physician substance use by medical specialty. J Addict Dis 1999; 18: 23–37
  • Bennet J, O'Donovan D. Substance misuse by doctors, nurses and other healthcare workers. Curr Opin Psychiatry 2001; 14: 195–9
  • Zacny J P, Galinkin J L. Psychotropic drugs used in anesthesia practice: abuse liability and epidemiology of abuse. Anesthesiology 1999; 90: 269–88
  • Verghese A. Physicians and addiction. N Engl J Med 2002; 346: 1510–1
  • Baird W L, Morgan M. Substance misuse amongst anaesthesiologists. Anaesthesia 2000; 55: 943–5
  • Christie J, Rosen I, Bellini L, et al. Presciption drug use and self-prescription among resident physicians. JAMA 1998; 280: 1253–5
  • Chambers R, Belcher J. Self-reported health care over the past 10 years: a survey of general practitioners. Br J Gen Pract 1992; 42: 153–6
  • Hughes P H, Conrad S E, Baldwin D C, et al. Resident physician substance abuse in the United States. JAMA 1991; 265: 2069–73
  • Bailey C P, Smith F L, Kelly E, Dewey W L, Henderson G. How important is protein kinase C in mu-opioid receptor desensitization and morphine tolerance?. Trends Pharmacol Sci 2006; 27: 558–65
  • Zhang X, Bao L, Guan J. Role of delivery and trafficking of delta-opioid peptide receptors in opioid analgesia and tolerance. Trends Pharmacol Sci 2006; 27: 324–9
  • Bell D M, McDonough J P, Ellison J S, Fitzhugh E C. Controlled drug misuse by Certified Registered Nurse Anesthetists. AANA J 1999; 67: 133–40
  • Merlo L J, Goldberger B A, Kolodner D, Fitzgerald K, Gold M S. Fentanyl and propofol exposure in the operating room: sensitization hypotheses and further data. 2007, On file with editors
  • Takita A, Masui K, Kazama T. On-line monitoring of end-tidal propofol concentration in anesthetized patients. Anesthesiol 2007; 106: 659–64
  • Hornuss C, Praun S, Villinger J, et al. Real-time monitoring of propofol in expired air in humans undergoing total intravenous anesthesia. Anesthesiology 2007; 106: 665–74
  • Rieder J, Keller C, Brimacombe J, et al. Monitoring pollution by proton-transfer-reaction mass spectrometry during paediatric anaesthesia with positive pressure ventilation via the laryngeal mask airway or uncuffed tracheal tube. Anaesthesia 2002; 52: 663–6
  • Sumner G, Lirk P, Hoerauf K, et al. Sevoflurane in exhaled air of operating room personnel. Anesth Analg 2003; 97: 1070–3
  • Kelly K L. The financial devastation of physician addiction. The financial devastation of physician addiction; 4773, http://www.pmdnet.com/article.cfm?ID= Physician's Money Dig 2007(July)
  • Emshoff J G, Price A W. Prevention and intervention strategies with children of alcoholics. Pediatrics 1999; 103: 1112–21
  • Breiner S J. The impaired physician. J Med Educ 1979; 54: 673
  • Vaillant G E, Clark W, Cyrus C, et al. Prospective study of alcohol treatment. Eight-year follow-up. Am J Med 1983; 75: 455–63
  • Reid W H. Evaluating and treating disabled or impaired colleagues. J Psychiatr Pract 2007; 13: 44–8
  • Harms B A, et al. A 25-year single institution analysis of health, practice, and fate of general surgeons. Ann Surg 2005; 242: 520–6
  • American Medical Association Council on Ethical and Judical Affairs. Reporting impaired, incompetent, or unethical colleagues. American Medical Association, Chicago 1992
  • Angres D, Busch K. The chemically-dependent physician: clinical and legal considerations. egal implications of hospital policies and procedures, R D Miller. Jossey Bass, San Francisco 1989; 21–32
  • Ross S. Clinical pearl: identifying an impaired physician. Virtual Mentor 2003; 5(12), http://virtualmentor.ama-assn.org/2003/12/cprl1-0312.html
  • Roberts K, Specker S. The health professionals services program: an alternative for physicians with psychiatric disorders. Minn Med 1999; 82: 54–6
  • Nace E P, Birkmayer F, Sullivan M A, et al. Socially sanctioned coercion mechanisms for addiction treatment. Am J Addict 2007; 16: 15–23
  • Fowlie D G. Doctors' drinking and fitness to practice. Alcohol Alcohol 2005; 40: 483–4
  • Monahan G. Drug use/misuse among health professionals. Subst Use Misuse 2003; 38: 1877–81
  • Walzer R S. Impaired physicians: an overview and update of the legal issues. J Leg Med 1990; 11: 131–98
  • American Society of Addiction Medicine patient placement criteria. ASAM, Chevy Chase, MD 2000
  • McGovern M P, Angres D H, Leon S. Differential therapeutics and the impaired physician: patient-treatment matching by specificity and intensity. J Addict Dis 1998; 17: 93–107
  • Angres D, Delisi S, Alam D, White B. A programmatic approach to treating physicians with a dual diagnosis. Psychiatr Ann 2004; 34: 776–80
  • Wettstein R M. Commentary: quality improvement and psychiatric fitness for duty evaluations of physicians. J Am Acad Psychiatry Law 2005; 33: 92–4
  • Washton A M, Gold M S, Pottash A C. Naltrexone in addicted physicians and business executives. NIDA Res Monogr 1984; 55: 185–90
  • Vinson S, Graham N A, Gold M S. Socioeconomic inequities often translate into health inequalities [Letter]. J Nat Med Assn 2006; 98: 816–7
  • Harmon L, Pomm R. Evaluation, treatment, and monitoring of disruptive physician behavior. Psychiatr Ann 2004; 34: 770–4
  • Putnam D, Williams R A, Weese D, et al. The effect of inpatient psychiatric hospitalization on weight gain in children and adolescents. Psychiatr Hosp 1990; 21: 119–23
  • Hodgkins C C, Jacobs W S, Gold M S. Weight gain after adolescent drug addiction treatment and supervised abstinence. Psychiatr Ann 2003; 33: 112–7
  • Hodgkins C C, Seraphine A E, Frost-Pineda K, Gold M S. Adolescent drug addiction treatment and weight gain. J Addict Dis 2004; 23: 55–65
  • Krahn D D, Kurth C, Demitrack M, et al. The relationship of dieting severity and bulimic behaviors to alcohol and other drug use in young women. J Subst Abuse 1992; 4: 341–53
  • Gosnell B A, Krahn D D, Yracheta J M, et al. The relationship between intravenous cocaine self-administration and avidity for saccharin. Pharmacol Biochem Behav 1998; 60: 229–36
  • Gosnell B A, Krahn D D. Taste and diet preferences as predictors of drug self-administration. NIDA Res Monogr 1998; 169: 154–75
  • Salmon P. Effects of physical exercise on anxiety, depression, and sensitivity to stress: a unifying theory. Clin Psychol Rev 2001; 21: 33–61
  • Van Rhenen W, Blonk R WB, van der Klink J JL, van Dijk F JH, Schaufeli W B. The effect of a cognitive and a physical stress-reducing programme on psychological complaints. Int Arch Occup Environ Health 2005; 78: 139–48
  • Martin C A, Talbott G. Women physicians in the Georgia Impaired Physicians Program. J Am Womens Med Assoc 1987; 42: 115–21
  • McGovern M P, Angres D H, Uziel-Miller N D, Leon S. Female physicians and substance abuse: comparisons with male physicians presenting for assessment. J Subst Abuse Treat 1998; 15: 525–33
  • McGovern M P, Angres D H, Shaw M, Rawal P. Gender of physicians with substance use disorders: clinical characteristics, treatment utilization, and post-treatment functioning. Subst Use Misuse 2003; 38: 993–1001
  • Angres D, McGovern M P, Shaw M F, Rawal P. Psychiatric comorbidity and physicians with substance use disorders: a comparison between the 1980s and 1990s. J Addict Dis 2003; 22: 79–87
  • Wijesinghe C P, Dunne F. Substance use and other psychiatric disorders in impaired practitioners. Psychiatr Q 2001; 72: 181–9
  • Enders L E, Mercier J M. Treating chemical dependency: the need for including the family. Int J Addict 1993; 28: 507–19
  • Eells M A. Interventions with alcoholics and their families. Nurs Clin North Am 1986; 21: 493–504
  • Skipper G E. Treating the chemically dependent health professional. J Addict Dis 1997; 16: 67–73
  • Roback H B, Moore R F, Waterhouse G J, Martin P R. Confidentiality dilemmas in group psychotherapy with substance-dependent physicians. Am J Psychiatry 1996; 153: 1250–60
  • Galanter M, Talbott D, Gallegos K, Rubenstone E. Combined Alcoholics Anonymous and professional care for addicted physicians. Am J Psychiatry 1990; 147: 64–8
  • Moos R H, Moos B S. Paths of entry in to Alcoholics Anonymous: consequences for participation and remission. Alcohol Clin Exp Res 2005; 29: 1858–68
  • Bogenschutz M P, Tonigan J S, Miller W R. Examining the effects of alcoholism typology and AA attendance on self-efficacy as a mechanism of change. J Stud Alcohol 2006; 67: 562–7
  • Zemore S E, Kaskutas L A. Helping, spirituality, and Alcoholics Anonymous in recovery. J Stud Alcohol 2004; 65: 383–91
  • Pagano M E, Friend K B, Tonigan J S, Stout R L. Helping other alcoholics in Alcoholics Anonymous and drinking outcomes: findings from Project MATCH. J Stud Alcohol 2004; 65: 766–73
  • Walsh D C, Hingson R W, Merrigan D M, et al. A randomized trial of treatment options for alcohol-abusing workers. N Engl J Med 1991; 325: 775–82
  • Crowley T J. Doctors' drug abuse reduced during contingency-contracting treatment. Alcohol Drug Res 1986; 6: 299–307
  • Anfang S A, Faulkner L R, Fromson J A, et al. The American Psychiatric Association's resource document on guidelines for fitness-for-duty evaluations on physicians. J Am Acad Psychiatry Law 2005; 33: 85–8
  • Anfang S A, Wall B W. Psychiatric fitness-for-duty evaluations. Psychiatr Clin North Am 2006; 29: 675–93
  • Meyer D J, Price M. Forensic psychiatry assessments of behaviorally disruptive physicians. J Am Acad Psychiatry Law 2006; 34: 72–81
  • Turnbull J, Cunnington J, Unsal A, Norman G, Ferguson B. Competence and cognitive difficulty in physicians: a follow-up study. Acad Med 2006; 81: 915–8
  • Shaw M F, McGovern M P, Angres D H, Rawal P. Physicians and nurses with substance use disorders. J Advanced Nurs 2004; 47: 561–71
  • Gold M S, Pomm R, Frost-Pineda K. Urine testing confirmed, 5-year outcomes of impaired physicians. Paper presented at meeting of World Psychiatric Association, Florence, Italy, November, 2004
  • Preston K L, Silverman K, Schuster C R, Cone E J. Comparison of self-reported drug use with quantitative and qualitative urinalysis for assessment of drug use in treatment studies. NIDA Res Monogr 1997; 167: 130–45
  • Harrison L D, Martin S S, Enev T, Harrington D. Comparing drug testing and self-report drug use among youth and young adults in the general population [DHHS Publication No. SMA 07-4249, Methodology Series M-7]. SAMHSA Office of Applied Studies, Rockville, MD 2007
  • Huestis M A, Cone E J. Differentiating new marijuana use from residual drug excretion in occasional marijuana users. J Anal Toxicol 1998; 22: 445–54
  • Cone E J, Sampson-Cone A H, Darwin W D, Huestis M A, Oyler J M. Urine testing for cocaine abuse: metabolic and excretion patterns following different routes of administration and methods for detection of false-negative results. J Anal Toxicol 2003; 27: 386–401
  • Kintz P, Villain M, Dumestre V, Cirimele V. Evidence of addiction by anesthesiologists as documented by hair analysis. Forens Sci Int 2005; 153: 81–4
  • Skipper G E, Weinmann W, Thierauf A, et al. Ethyl glucoronide: a biomarker to identify alcohol use by health professionals recovering from substance use disorders. Alcohol Alcohol 2004; 39: 445–9
  • Peace M R, Tarnai L D. Performance evaluation of three on-site adulterant detection devices for urine specimens. J Anal Toxicol 2002; 26: 464–70
  • Valtier S, Cody J T. A procedure for the detection of Stealth adulterant in urine samples. Clin Lab Sci 2002; 15: 111–5
  • Jacobs W S, Hall J D, Pomm R, et al. Prognostic factors for physician addiction outcomes at five years. Paper presented at annual medical-scientific meeting of the American Society of Addiction Medicine, Washington, DC, April, 2004
  • Frost-Pineda K, Gold M S, Pomm R, Jacobs W S, Repetto M. Randomized urine testing: a safe and effective intervention for drug addiction. Paper presented at annual meeting of American College of Clinical Pharmacology, Palm Harbor, FL, September, 2003
  • Jacobs W S, Repetto M, Vinson S, Pomm R, Gold M S. Random urine testing as an intervention for drug addiction. Psychiatr Ann 2004; 34: 781–4
  • Shore J. The Oregon experience with impaired physicians on probation: an eight year follow-up. JAMA 1987; 257: 2931–4
  • Corsino B V, Morrow D H, Wallace C J. Quality improvement and substance abuse: rethinking impaired provider policies. Am J Med Qual 1996; 11: 94–9
  • McLellan A T, Carise D, Kleber H D. Can the national addiction treatment infrastructure support public's demand for quality case?. J Subst Abuse Treat 2003; 25: 117–21
  • Brownell K D, Marlatt G A, Lichtenstein E, Wilson G T. Understanding and preventing relapse. Am Psychol 1986; 41: 765–82
  • Miller W R, Sanchez-Craig M. How to have a high success rate in treatment: advice for evaluators of alcoholism programs. Addiction 1996; 91: 779–85
  • Volkow N D, Li T K. Drugs and alcohol: treating and preventing abuse, addiction and their medical consequences. Pharmacol Ther 2005; 108: 3–17
  • Newbury-Birch D, Walshaw D, Kamali F. Drink and drugs: from medical students to doctors. Drug Alcohol Depend 2001; 64: 265–70
  • Newbury-Birch D, White M, Kamali F. Factors influencing alcohol and illicit drug use amongst medical students. Drug Alcohol Depend 2000; 59: 125–30
  • Flynn J R. Treating the impaired physician: the hospital's role. Hosp Prog 1980; 61: 44–7
  • Mavroforou A, Giannoukas A, Michalodimitrakis E. Alcohol and drug abuse among doctors. Med Law 2006; 25: 611–25
  • Gold M S, Aronson M. This issue: physician health and impairment. Psychiatr Ann 2004; 34: 736–41
  • Ziegler P P. Monitoring impaired physicians: a tool for relapse prevention. Penn Med 1992; 95: 38–40

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.