Substance-use disorders among physicians: special treatment considerations.
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Biomedical subjects
Publications and source records attributed to R E Herrington.
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Of 40 participants of a two-year program for rehabilitating alcohol- and other-drug-dependent physicians, 15 have completed 24 months of treatment and monitoring, eight have completed 12 to 23 months, ten have completed one to 11 months, and seven discontinued treatment before completion. Of the 33 treated physicians, 31 have returned to full practice and 22 have experienced no relapse. The prognosis is quite favorable for most impaired physicians in appropriate treatment, monitoring, and follow-up are provided.
Physicians recovering from substance-use disorders face many reintegration problems when they attempt to resume professional activities. Armed with state-of-the-art information, hospital medical staffs and administrators can ensure that the process is as smooth as possible and that the recovering physician's, the patient's, and the hospital's rights are protected.
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The possible use of high density lipoprotein cholesterol (HDLC) as a marker of alcohol abuse was studied in 92 alcoholic patients entering an inpatient treatment program. The average HDLC levels of 68 male patients (66 +/- 23 mg/dl) and 24 female patients (83 +/- 18 mg/dl) were significantly higher than the values for the corresponding control groups of similar ages. Approximately 20% of the male patients had HDLC levels over the mean +/- 2 SD over the control groups. Following 2 wk of alcohol abstinence, the HDLC levels decreased to the control range. HDLC, as a measure of alcohol abuse, may be especially useful in combination with determination of gamma glutamyl transpeptidase (GGT), since these two tests singly or in combination were elevated in 65% of the male and 85% of the female patients.
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