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Médecine du travail du personnel hospitalier

The prevalence of substance use disorders in American physicians

Auteur     Michael R. Oreskovich
Auteur     Tait Shanafelt
Auteur     Lotte N. Dyrbye
Auteur     Litjen Tan
Auteur     Wayne Sotile
Auteur     Daniel Satele
Auteur     Colin P. West
Auteur     Jeff Sloan
Auteur     Sonja Boone
Volume     24
Numéro     1
Pages     30-38
Publication     The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions
Date     Jan 2015
Langue     eng
Résumé     BACKGROUND: There have been few studies on the prevalence of substance use disorders (SUDS) in the physician population at large nor have any studies compared the prevalence of SUDS in American physicians by specialty. METHODS: We conducted a national study of SUDS in a large sample of U.S. physicians from all specialty disciplines using the AMA Physician Masterfile. Substance Use Disorders (SUDS) were measured using validated instruments. RESULTS: Of the 27,276 physicians who received an invitation to participate, 7,288 (26.7%) completed surveys. 12.9% of male physicians and 21.4% of female physicians met diagnostic criteria for alcohol abuse or dependence. Abuse of prescription drugs and use of illicit drugs was rare. Factors independently associated with alcohol abuse or dependence were age (OR = .985; p < .0001), hours worked (OR = .994; p = .0094), male gender (OR = .597; p < .0001), being married (OR 1.296; p = .0424) or partnered (OR 1.989; p = .0003), having children (OR .745; p = .0049), and being in any specialty other than internal medicine (OR 1.757; p = .0060). Specialty choice was strongly associated with alcohol abuse or dependence (p = .0011). Alcohol abuse or dependence was associated with burnout (p < .0001), depression (p < .0001), suicidal ideation (p = .0004), lower quality of life (p < .0001), lower career satisfaction (p = .0036), and recent medical errors (p = .0011). CONCLUSION: Alcohol abuse or dependence is a significant problem among American physicians. Since prognosis for recovery of physicians from chemical dependency is exceptionally high, organizational approaches for the early identification of problematic alcohol consumption in physicians followed by intervention and treatment where indicated should be strongly supported.

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