Abstract
The issues discussed in this article introduce and examine topics related to physicians' health which are salient in their clinical usefulness or their heuristic value in planning future research. Physicians in general possess physical, emotional and intellectual strengths that are needed to face high stress and low social support. Physicians are also less likely to seek routine medical care. With many illnesses physicians are inherently resistant but have higher risk factors. It is postulated that the opposing tendencies cancel each other. Physicians have better intrinsic physical and mental health but live under higher stress and get less routine preventive care. Physicians also may have a tendency to live healthy lives without addiction but have high risk factors for addiction. Adults who have grown up in families with addiction have a tendency to choose health care professions. Genetic composition may predispose to alcoholism and other chemical addictions. Taking into consideration inherent health and risk it is thought that physicians have a similar prevalence of alcoholism and drug dependence as compared to the general population. Physicians have higher access to pharmaceutical drugs but are less inclined to use street drugs. In the New York State Physicians' Health Program, 88% of the participants used alcohol or prescription drugs and only 12 percent used marihuana or Cocaine. Additional risk factors for Substance Use Disorders in Physicians have been postulated to be pharmacological optimism, intellectual strength, strong will, love of challenges, instrumental use of medications and a daily need for denial. These factors require rigorous investigation to establish their role. Clinical approaches and techniques discussed include the incubation period for a Substance Use Disorder, initial high tolerance, state dependent learning, and the signal properties of drugs. As recovery progresses it is postulated that it becomes increasingly important to deal with substitute addictions and family of origin issues.
Similar content being viewed by others
REFERENCES
Frank E, Research Issues for Physician Health Programs in Prevention and Special Populations at the Physician Health Research Conference, Estes Park, Colorado, September 15 to 17, 1996
Frank E; Brogan DJ; Mokdad AH; Simoes EJ; Kahn HS, Health-related behaviors of women physicians vs other women in the United States, Arch Intern Med, 158:342–8, 1998.
Cohn JM; Koenig F; Baum N, Preventive Healthcare in Physicians and Attorneys. J La State Med Soc, 50:264–70, 1998.
Mansky PA, Mansky, P. A., Helping Addicted Physicians: Integrating Clinical, regulatory, Advocacy and Legal Concerns, Faculty, Workshop, Arnold Washton, Moderator, 1998 International Conference on Physician Health, Victoria, British Columbia, May 2, 1998.
Centrella, MC, Physician addiction and impairment-current thinking: A review, Journal of Addictive Diseases, 13:91–105, 1994.
Talbott GD, Gallegos KV, Angres DH, Impairment and Recovery in Physicians and Other Health Professionals, in Graham AW, Scultz, TK, Principles of Addiction Medicine Second Edition, 1263–79, 1998.
Schuckit MA, Smith TL Assessing the risk for alcoholism among sons of alcoholics, J Stud Alcohol 58:141–51, 1997.
Schuckit MA, A 10-year follow-up of sons of alcoholics: preliminary results, Alcohol Alcohol Suppl; 1:147–9, 1991
Schuckit MA, Genetics and the risk for alcoholism, JAMA, 254:2614–7, 1985
Richman JA, Pyskoty CE Interpersonal versus technological orientations and alcohol abuse in future physicians, Br J Addict, 86:1133–8, 1991
Wittman PP, The relationship between choice of college major and prevalence of adult children of alcoholics, J Allied Health, 19:245–50, 1990
Crosby LR, Reilly CA, Bissell L, To Care Enough: Intervention with Chemically Dependent Colleagues: A Guide for Healthcare & Other Professionals, 1989.
Weissberg, MP, Panel for: Research Issues for Physician Health Programs in Prevention and Special Populations at the Physician Health Research Conference, Estes Park, Colorado, September 15 to 17, 1996
Cassem NH, Hackett TP, Psychological aspects of myocardial infarction, Med Clin North Am, 61:711–21, 1977.
Cassem NH, Hackett TP, Caring for the cardiac patient. “Ego infarction” psychological reactions to a heart attack, J Pract Nurse, 29:17–20, 1979.
Dimsdale JE, Hackett TP, Effect of denial on cardiac health and psychological assessment, Am J Psychiatry, 139:1477–80, 1982
Hackett TP, Cassem NH, Coping with cardiac disease, Adv Cardiol, 31:212–7, 1982.
Skipper GE, Treating the Chemically Dependent Health Professional, J Addictive Diseases, 16:97–73, 1997
Vaillant, GE, The Natural History of Alcoholism Revisited, 1995
Gawin FH, Kleber HD, Byck R, Rounsaville BJ, Kosten TR, Jatlow PI, Morgan C, Desipramine facilitation of initial cocaine abstinence, Arch Gen Psychiatry, 46:117–21, 1989.
Schuckit MA, Tipp JE, Smith TL, Wiesbeck GA, Kalmijn J, The relationship between Self-Rating of the Effects of alcohol and alcohol challenge results in ninety-eight young men, J Stud Alcohol, 58:397–404, 1997.
Schuckit MA, Tsuang JW, Anthenelli RM, Tipp JE, Nurnberger JI Jr, Alcohol challenges in young men from alcoholic pedigrees and control families: a report from the COGA project, J Stud Alcohol, 57:368–77, 1996
Schuckit MA, Duthie LA, Mahler HI, Irwin M, Monteiro MG, Subjective feelings and changes in body sway following diazepam in sons of alcoholics and control subjects, J Stud Alcohol, 52:601–8, 1991
Schuckit MA, Subjective responses to alcohol in sons of alcoholics and control Subjects, Arch Gen Psychiatry, 41:879–84, 1984
Ehlers CL, Schuckit MA, Evaluation of EEG alpha activity in sons of alcoholics, Neuropsychopharmacology, 4:199–205, 1991
Schuckit MA, Subjective responses to alcohol in sons of alcoholics and control subjects, Arch Gen Psychiatry, 41:879–84, 1984
Schuckit MA, Ethanol-induced changes in body sway in men at high alcoholism risk, Arch Gen Psychiatry 42:375–9, 1985
Anthenelli R. M. and Schuckit M.A., Genetic Studies of Alcoholism, Int JAddict, 25:81–94, 1990.
Schucket M.A., Biological Vulnerability to Alcoholism, J. Consult Clin Psychol 55:301–309, 1987.
Mansky PA, Reminiscence of an addictionologist: thoughts of a researcher and clinician, Psychiatr Q, 64:81–106, 1993.
Overton, D.A. Control of Behavior by Drug States, in T. Thomsen, R. Pickens, eds, Stimulus Properties of Drugs, Appleton Century Croft, New York, p. 87–110, 1971.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Mansky, P.A. Issues in the Recovery of Physicians from Addictive Illnesses. Psychiatr Q 70, 107–122 (1999). https://doi.org/10.1023/A:1022197218945
Issue Date:
DOI: https://doi.org/10.1023/A:1022197218945