Abstract
In order to determine the prevalence of psychoactive substance use in three specialty groupings, 1,624 questionnaires were sent to physicians in medicine, surgery and anaesthesia; all had trained at the same academic institution. A response rate of 57.8% was achieved. Comparison of prevalence of impairment rates showed no differences between Surgery (14.4%), Medicine (19.9%) and Anaesthesia (16.8%). Substance abuse was clearly associated with a family history of abuse; 32.1% of the abusers had a family history of such abuse compared with 11.7% of the non-abusers. Increased stress at various career stages did not appear to increase substance abuse; problem areas during medical life times were similar for each specialty. Substances most frequently used were marijuana (54.7%), amphetamines (32.9%); and benzodiazepines (25.1%). Seventy-three used psychoactive drugs which were non-prescribed. Drug counselling programmes were judged inadequate by most. Use of alcohol and drugs by faculty members was reported by a number of respondents.
Résumé
Dans le but de déterminer l’habitude des produits psychoactifs chez trois groupes de spécialistes, 1,624 questionnaires ont été expédiés à des internistes, des chirurgiens et à des anesthésistes. Tous avaient reçu leur formation à la même institution. Le taux de réponse a été de 57,8%. La fréquence ne diffère pas entre chirurgiens (14,4%), internistes (19,9%) et anesthésistes (16,8%). L’usage des toxiques est nettement associée à une histoire familiale d’abus des drogues; 32,1% des utilisateurs avaient une histoire familiale positive comparativement à 11,7% des non utilisateurs. L’augmentation du stress à des moments variés de la vie profesionnelle ne semble pas influer sur l’abus des toxiques; les périodes de difficultés professionnelles sont identiques pour les trois disciplines. Les substances les plus utilisées sont la marihuana (54,7%), les amphétamines (32,9%) et les benzodiazépines (25,1%). Soixantetreize des répondants ont fait usage de médicaments psychoactifs non prescrits. La plupart ont jugé les programmes d’aide inadéquats. L’utilisation de l’alcool et des drogues par le personnel médical a été rapportée par une certain nombre de répondants.
Article PDF
Similar content being viewed by others
References
Clark DC. Alcohol and drug use and mood disorders among medical students: implications for physician impairment. QRB Qual Rev Bull 1985; 14: 50–4.
McAuliffe WE, Rohman M, Fishman P, et al. Psychoactive drug use by young and future physicians. J Health Soc Behav 1984; 25: 34–54.
Baldwin DC Jr,Conard S, Hughes P, Achenbach KE, Sheehan DV. Substance use and abuse among senior medical students in 23 medical schools. Proceedings of the Annual Conference on Research in Medical Education 1988; 27: 262–7.
Kory WP, Crandall LA. Nonmedical drug use patterns among medical students. Int J Addict 1984; 19: 871–84.
Maddux JF, Hoppe SK, Costello RM. Psychoactive substance use among medical students. Am J Psychiatry 1986; 1432: 187–91.
Ward CF, Ward GC, Saidman LJ. Drug abuse in anesthesia training programs. JAMA 1983; 250: 922–5.
Urbach JR, Levenson JL, Harbison JW. Perceptions of housestaff stress and dysfunction within the academic; medical center. Psychiatr Q 1989; 60: 283–96.
Conard SE, Hughes P, Baldwin D, Achenbach K, Sheehan D Substance use and the resident physician: a national study. Proceedings of the Annual Conference on Research in Medical Education 1988; 27: 256–61.
Maddux JF, Timmerman IM, Costello RM. Use of psychoactive substances by residents. Journal of Medical Education 1987; 62: 852–4.
Sethi BB, Manchanda R. Drug abuse among resident doctors. Acta Psychiatr Scand 1980; 62: 447–55.
Gallegos KV, Browne CH, Veit FW, Talbott GD. Addiction in anesthesiologists: drug access and patterns of substance abuse. QRB Qual Rev Bull 1988; 14: 116–22.
Logan WS. The evaluation of the impaired physician. New Dir Ment Health Serv 1989; 41: 33–53.
McAuliffe WE, Rohman M, Santangelo S, et al. Psychoactive drug use among practicing physicians and medical students. N Engl J Med 1986; 315: 805–10.
Angres DH, Busch KA. The chemically dependent physician: clinical and legal considerations. New Dir Ment Health Serv 1989; 41: 21–32.
Herrington RE, Benzer DG, Jacobson GR, Hawkins MK. Treating substance-use disorders among physicians. JAMA 1982; 247: 2253–7.
Menk EJ, Baumgarten RK, Kingsley CP, Culling RD, Middaugh R. Success of reentry into anesthesiology training programs by residents with a history of substance abuse. JAMA 1990; 263: 3060–2.
Talbott GD, Gallegos KV, Wilson PO, Porter TL. The medical association of Georgia’s Impaired Physicians Program. JAMA 1987; 257: 2927–30.
Lecky JH, Aukburg SJ, Conahan TJ 3rd,et al. A departmental policy addressing chemical substance abuse. Anesthesiology 1986; 65: 414–7.
Lutsky I, Abram SE, Jacobson GR, Hopwood M, Kampine JP. Substance abuse by anesthesiology residents. Acad Med 1991; 66: 164–6.
Luetgert MJ, Armstrong AH. Methodological issues in drug usage surveys: anonymity, recency and frequency. Int J Addict 1973; 8: 683–9.
Ewing JA. Detecting alcoholism. The CAGE questionnaire. JAMA 1984; 252: 1905–7.
Snedecor GW, Cochran WG. Statistical Methods, 6th Ed, Ames, IA: Iowa State University Press 1967; 246–8.
Kahn HA. An introduction to Epidemiologic Methods. New York: Oxford University Press, 1983; 100–11.
Pokorny AD, Solomon J. A follow-up survey of drug abuse and alcoholism teaching in medical schools. Journal of Medical Education 1983; 58: 316–21.
Lewis DC, Niven RG, Czechowicz D, Trumble JG. A review of medical education in alcohol and other drug abuse. JAMA 1987; 257: 2945–8.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Lutsky, I., Hopwood, M., Abram, S.E. et al. Use of psychoactive substances in three medical specialties: anaesthesia, medicine and surgery. Can J Anaesth 41, 561–567 (1994). https://doi.org/10.1007/BF03009992
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF03009992