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A new study estimates that 12 percent of doctors have an addiction problem. That's only slightly higher than the general population. Still, when physicians suffered from addiction, it's not just their problem. There have been disturbing stories about inadequate treatment, botched surgeries, even death. Forty-eight states provide some sort of confidential diversion programs to get addicted doctors into treatment. Washington states' program is considered one of the best.
From member station KUOW in Seattle, reporter Patricia Murphy profiles one doctor and how the Washington Physicians Health Program helped him.
PATRICIA MURPHY: By the time David entered Seattle's Virginia Mason Hospital as an anesthesia resident, his alcohol use was escalating. When he couldn't drink, he would suffer withdrawal symptoms like sleeplessness and irritability.
DAVID: It started to cause a lot of problems with staff at the hospital. I developed somewhat of a reputation as being kind of a - a hothead, and I was reprimanded several times for bad interactions with the nursing staff.
MURPHY: After being warned by his supervisors about his combative behavior, David began using opiates to take the edge off. At first he used oxycodone, but eventually he started using an anesthesia drug called fentanyl. It's a hundred times more powerful than morphine. It wasn't long before David could barely go an hour without using. He started stealing from his patients during surgeries.
Dr. DAVID: Even though my patients weren't in actual fact getting this medicine, if you looked at my record with checking the medicine out, it looked like I was quite liberal with administrating it to my patients, when in actual fact it was all going to me.
MURPHY: When their local anesthesia wore off, David's patients would have unusually intense pain. Post-op nurses were baffled by this since the charts showed their patients were fully loaded with pain-killing drugs. By diverting a narcotic medication, David had committed a felony.
Dr. DAVID: I absolutely hated what I was doing. I knew it was massively wrong and there was just no - no way I could justify it, and yet I was unable to not do it. And this was extremely demoralizing to me.
MURPHY: As David's addiction to fentanyl became all-consuming, his behavior became more risky.
Dr. DAVID: I couldn't check enough to satisfying my needs without drawing attention to myself. And so I started going through the syringe discard buckets on the anesthesia carts in the operating room. And that's how I got caught.
Mr. SCOTT ALBERTI (Washington Physicians Health Program): It's a shock. I know it is a shock for all of them, but I think at the same time there may be a part of them when they know they're coming in to see me that the jig is up.
MURPHY: That's Scott Alberti, the Washington Physicians Health Program interventionist. His soothing yet serious message of hope is as much about protecting patients as it is about getting help to doctors. Post-intervention, most physicians from Washington end up at Hazelden Springbrook, a treatment program in Newburgh, Oregon. The 90 days of intensive treatment take place in a special unit for health care workers.
Dr. Mick Oreskovich is the WPHP's medical director. He says his program along with a handful of similar doctor diversion programs has a particularly high success rate. Seventy-five percent of participants will achieve long term recovery. That's three times higher than for substance abuse programs for the general population. Oreskovich says the WPHP's credibility is based on three things.
Dr. MICK ORESKOVICH (Washington Physicians Health Program): The first is monitoring, the second is monitoring, and the third is monitoring - worksite monitor that gets back to us with reports of unusual behavior; chemical monitoring, which is testing urine, blood, hair, fingernails for substances of abuse; and then professional monitoring, where they attend an hour and a half group each week. Between those three forms of monitoring, we pick up relapse at a very, very early stage.
MURPHY: Physicians agree to comply for five years after treatment. During that period they can gain the program's endorsement that they're safe to practice provided they remain substance free. The WPHP's methods have gained national attention. The program is now part of a study to determine whether this treatment model could apply to the general population. Relapses do happen. David entered treatment when he was 29; he would be 40 by the time he finally got sober. For starters, he refused to admit that alcohol was part of his addiction.
Dr. DAVID: I resisted them. I said, no, I'll quit injecting fentanyl but when I get out of here I'm going to drink again. It's legal and you can't stop me. They said, well, we're not going to let you out then, until you change your mind. And they literally kept me there for five months.
MURPHY: David still resisted. He lost his residency. Over the course of 10 years he surrendered his medical license; his marriage fell apart; he worked as a fishmonger and in construction. Finally, it was David's desire to be a father to his young daughter that gave him the strength to get sober. He reentered the treatment program and eventually regained his license. He now works in private practice treating chronic pain patients in Seattle.
For NPR news, I'm Patricia Murphy in Seattle.
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