Alcoholism and Medical Professionals

Due to the nature of their positions, healthcare workers in the United States may be at risk for becoming addicted to drugs and/or alcohol.¹ Further, this can pose a serious risk to the public’s safety if they are impaired while at work. For healthcare professionals (HCPs), the Federation of State Medical Boards defines impairment as the inability to perform duties with reasonable skill and safety under their designated healthcare license as a result of certain conditions.² These conditions may be a mental disorder, physical illness, or a substance use disorder (SUD).²

Thankfully, early intervention with the appropriate treatment of alcohol use disorder (AUD) and other SUDs usually results in remission that often leads to full recovery.² Research shows that the likelihood of regaining optimal health increases with continued care and ongoing monitoring.² However, untreated alcohol use disorder increases the risk of serious health problems and other negative consequences.³

 

Understanding Alcoholism in Healthcare Professionals

Research data on substance abuse of healthcare professional vary widely.⁴ Data from the Substance Abuse and Mental Health Services Administration (SAMHSA) as well as other studies suggest that as an industry, healthcare workers drink less than the general population.^1,5

Additional data shows that physicians, however, may consume more alcohol than the general population and it’s estimated that approximately 10-12% of physicians will develop a substance use disorder during their careers—a rate similar to and slightly exceeding that of the general population.^4,6 Additionally, although most states offers some form of an impaired professionals’ program, HCPs may be reluctant to report their substance abuse to co-workers.^2,7

 A study by the personal injury law firm Anapol Weiss (AW) pulled statistics from the National Practitioner Data Bank related to medical professionals who received disciplinary actions from 1999-2017.⁸ AW found 99,367 documented cases of adverse actions taken against healthcare workers due to drug and alcohol abuse during this period.⁸ The study also revealed differences in alcohol and drug abuse among professionals, especially nurses.⁸

The nearly 2 decades of compiled data identified registered nurses (RNs) as having 5 times more drug and alcohol violations than doctors, with a total of 41,462 actions invoked.⁸ Licensed practical nurses (LPNs) had the second most violations at 19,564.⁸ Medical doctors (MDs) and doctors of osteopathic medicine (DOs) had a combined total of 8,542.² Of all the substances abused in this study, alcohol was involved in 56% of cases that ended in board actions brought against HCPs.¹ The second most common violation was the diversion of controlled substances.⁸

Risk Factors for Alcoholism in Healthcare Professionals

Alcoholism, like other SUDs, can be exacerbated by many factors such as genetics, comorbid conditions, and an individual’s environment.⁹ Many theories aim to explain what factors contribute to addiction among HCPs. Some point to career stressors such as exposure to trauma and death, which may be related to emotional and psychiatric distress.¹

Other studies looked at factors that might affect physicians and nurses such as workload, rotating shifts and lack of sleep.^9,10 The strongest predictor of alcohol or drug problems in HCPs, however, is a family history of alcoholism, which is the same as in the general population.^4,11 Other precursors associated with alcohol abuse in physicians include tobacco use, regular use of alcohol, and anxiety or anger as a reaction to stress.¹¹

For physicians, one study reported isolation to be a risk factor for worsening SUD, possibly due in part to their elevated social status.⁶ Some social isolation is not uncommon with addiction, but the social stigma may be greater for physicians, who are in a profession that exemplifies health and wellness.⁶

This stigma may penetrate individuals who are suffering from addiction; in some cases, being so severe that they delay seeking help.⁶ Family members and coworkers may not say anything and essential enable the behavior, as their economic wellbeing could be threatened by job and income loss.⁷ This can add to the severity and progression of the illness and can even lead to unintentional overdose or suicide.⁶

Alcohol Abuse by Profession

Alcohol use occurs across the spectrum of healthcare professionals, with several studies indicating that some HCPs have more instances of alcohol use or alcohol use disorders than others. Below are alcohol abuse rates by profession:

• Dentists: This group self-reported consuming more alcohol than other HCPs. Dentists also self-reported having more offers to drink in social situations.¹²
• Pharmacists: Estimates of AUD are in line with the general population with some studies pointing a slightly higher prevalence of SUDs, specifically for opioids and anxiolytics. A study of student pharmacists estimated that 25-30% of pharmacy students engaged in hazardous or binge drinking.¹³
• Physicians: 10-12% of physicians will develop a chemical dependency during their lifetime; 50.3% of which are alcohol related.^4,6
• Nurses: Substance abuse in nurses is similar to the general population with approximately 10% of nurses struggling with alcohol abuse and 6% having problems serious enough to interfere with their jobs.^14,15

Stress and Alcohol Abuse

While not every person experiencing stress or trauma will turn to alcohol abuse to cope, there is a strong connection between alcohol and stress, according to the National Institute of Alcohol Abuse and Alcoholism (NIAAA).¹⁶ Alcohol plays a part in both alleviating stress and prolonging it.¹² Stress is multidimensional; it can stem from various causes such as general life stressors, catastrophic events, childhood trauma, and racial and ethnic minority stress.¹⁶

Some individuals may look to decrease their anxiety by consuming alcohol.¹⁷ Since alcohol is a depressant, the initial alcohol intake may have the desired effect.¹⁷ But over time, the physiological stress response is exacerbated.¹⁷ Exposure to trauma may increase people’s alcohol use as well, and this has the potential to cause other anxiety symptoms (e.g., panic attacks, phobias, incapacitating worry, or depression).¹⁸

With this in mind, it’s understandable that healthcare professionals who are exposed to traumatic events may be at risk for abusing alcohol or developing an AUD over time if treatment for these precursors is not addressed.

Warning Signs of Alcohol Abuse

When trying to understand a person’s drinking habits and establish if they are struggling with alcoholism, it can be beneficial to know the warning signs of an alcohol use disorder. A person does not need to drink every day to have an AUD. Excessive alcohol use such as binge and heavy drinking can lead to dependency or alcoholism.¹⁹

Binge drinking occurs when a person’s blood alcohol concentration level is greater than or equal to 0.08 g/dl or above.¹⁹ Binging would be about 5 or more alcoholic drinks for men and 4 or more drinks for women.¹⁹ This amount of consumption does not necessarily mean a person has an AUD, however, this type of drinking could progress to heavy drinking.¹⁹

Heavy drinking is when women consume 8 or more drinks per week and men drink 15 or more alcoholic beverages per week.²⁰ Both types of drinking can be harmful, with binge drinking possibly leading to adverse events such as violence, STDs, chronic diseases and serious injuries.¹⁹ Heavy drinking is associated with tolerance, dependence, withdrawal, and other health consequences such as fibrosis, cirrhosis, and heart disease.²¹

Those who are struggling with AUD may experience a variety of circumstances. Among them: drinking alcohol first thing in the morning to calm the nerves, knowing they ought to cut down on their drinking, feeling guilty about drinking, or having others criticize their drinking.²² When alcohol dependence occurs, the body needs alcohol to function; when drinking is ceased or decreased individuals may experience acute symptoms of withdrawal.²² This means the person may experience trouble sleeping, shakiness, anxiety, nausea and/or sweating.²²

Symptoms of Alcohol Abuse

In the workplace, some warning signs of problematic drinking habits in those who may be struggling with alcohol abuse include:²³

• Smells of alcohol.
• Staggering.
• Mood and behavior changes.
• Avoidance of colleagues.
• Tremors.
• Unexplained absences during the workday.
• Frequent tardiness (e.g., the start of shift or meetings).

Other signs to look for are explained here see full list.

Alcohol Treatment for Healthcare Professionals

In general, treatment for alcohol use disorder involves a variety of therapeutic interventions and evidence-based practices. However, for HCPs, specific treatment programs are offered since state medical boards and physician health programs typically require higher levels of treatment interventions for patient safety.^4,6

Unfortunately, though, there are certain perceived barriers for those seeking recovery from alcoholism such as the fear of losing their job if they disclose their alcohol use to their employer.²⁴ These can be overcome with help from treatment providers who specialize in addiction care for impaired professionals. Most states have licensing boards that offer special programs to help caregivers get the treatment they need.^4,6 If you are a licensed HCP in need of rehab, you may contact your state board or physician health program about your treatment options.^4,6

Physicians can also contact their state medical board or physician health program to get expert advice, guidance, and resources to facilitate intervention and leverage the benefits of the program.^4,6 PHPs are designed to support healthcare professionals by providing a therapeutic alternative to discipline for those with potentially impairing illnesses such as addiction.²

 

Resources for Healthcare Professionals

There are many resources that healthcare professionals can tap into to gather the information they need to make an informed decision about seeking treatment for alcoholism or other SUD. These include:

• Board of Nursing
• Committee for Physician Health
• International Doctors in Alcoholics Anonymous
• National Association of Boards of Pharmacy
• National Institute on Drug Abuse
• Pharmacy Recovery Network
• Alcoholics Anonymous
• Narcotics Anonymous
• SMART Recovery

Get Help for Alcohol Addiction

If you’re a healthcare professional struggling with alcohol abuse or a substance use disorder, American Addiction Centers (AAC) can help. Alcohol.org is a subsidiary of AAC, a nationwide provider of addiction treatment centers.

Among our facilities, we offer specialized groups and programs for licensed professionals at our Recovery First and Greenhouse facilities in Florida and Texas, respectively. Because healthcare professionals face a unique set of challenges in recovery, our programs are tailored to addresses your specific needs of working in high-stress settings.

Our programs can help professionals with learn how to cope with the pressures of these demanding careers, discuss licensing issues and better understand how to prioritize recovery while managing the demands of your profession.

To speak with an admissions navigator about your treatment options today, call our hotline at . We’re available 24/7 and all calls are 100% confidential. Remember, you’re not alone and recovery from alcohol abuse and alcoholism is possible. We’ll be with you every step of the way as you work toward a life free from alcohol.

---

---