Substance abuse in anaesthetists
Key points Approximately 10 14% of all doctors will become substance dependent over their lifetime; the incidence in anaesthetists being 2.7 times greater than other physician groups.1,2 Including alcohol, studies describe 0.86 2% of anaesthetic trainees and 1.3% of consultants being addicted; if alcohol is excluded, drug addiction occurs in 1.6% of trainees and 1% of non training grades.1,3,4 Sixty two per cent of residency programme directors in the USA reported at least one trainee with a substance abuse problem and a worrying progressive increase in incidence was noted, being highest over the 10 yr since 2003.3,4 Anaesthetists are over represented at treatment centres in the USA with 2.5 times greater attendances compared with other physician groups.2 Conversely at the Practitioners Health Programme (PHP) in London, anaesthetists appear to be under represented, possibly meaning anaesthetists are either not coming forward for help or they are being managed elsewhere, as it is unlikely that the incidence is appreciably lower in the UK (C. Gerada, Medical Director, The Practitioner Health Programme, London, personal communications and unpublished data) Substance abuse has been defined as 'the repeated, excessive or inappropriate use of a mood altering substance resulting in negative consequences+ in one or more life areas, and where addiction cannot be diagnosed' (M. Kaufmann, Medical Director, Ontario Medical Association Physician