With the imminent emergency of the Covid virus subsiding, discussions have shifted from the physical dangers to concern about its lasting psychological effects. Healthcare organizations report alarming levels of stress, burnout, anxiety, and depression in employees, especially clinicians. This sharp rise should bring another equally troubling issue to the conversation: substance use disorders and addiction among healthcare providers and professionals.
Recognizing a Problem
Historically, the rate of addiction among physicians, nurses, and other clinicians has commonly mirrored that of the general population. However, there has never been an event as physically and mentally taxing on the healthcare industry as the Covid pandemic. The constant unknown and the exposure to trauma by those on the front lines, combined with isolation and a lack of the usual social outlets, creates a worst-case scenario for those with any kind of substance use disorder.
As an industry, we must recognize addiction as a mental health disorder and provide support for those who need help. Otherwise, as coined by some, it's a potential "pandemic within a pandemic."
Knowing the Signs
The first step is to be aware of the signs of a potential substance problem. Some common signs include:
- Excessive absenteeism
- Fatigue or hyperactivity
- Changes in personality
- Frequent confusion or memory problems
- Physical symptoms such as shaking, dilated pupils, rapid weight changes, or a constantly running nose
- Lack of hygiene or a sloppy appearance
- Frequent breaks
- Recurring errors in recordkeeping
- Excessive drug waste
- Decreased dependability and/or increased lying
- Recent financial or legal issues
In many cases, providers who are suffering with addiction manage to continue without showing a noticeable decline in their quality of work, which makes it critical to address these behavior or physical changes early on.
Resources for Help
Though they often make a referral for their patients, some medical professionals are reluctant to seek treatment for addiction issues, even when they recognize that they have a problem. A recent study found many are unsure of where to turn or are afraid to admit any mental distress to a supervisor due to the fear of professional repercussions, including the possibility of losing their license.
Nearly every state, including Alabama, offers screening and resources through a physician health program (PHP) or professional board. These programs provide confidential support and referrals to specialty treatment programs designed for safety-sensitive professionals and offer alternatives to disciplinary action. The comprehensive care management of PHPs or similar programs includes evidence-based care, monitoring, and peer support. This combination has been proven to help physicians and other clinicians find long-term recovery and successfully return to practice.
Eliminating the Stigma
While the stigma around mental health has lessened in recent years, many still feel that admitting a substance use issue means they are weak or not suited for the medical field. In my years of practicing addiction medicine, I have treated excellent doctors and nurses, many of whom return to practice and find greater success in their work.
Eliminating this stigma requires education and outreach from both peers and employers. It also means consistently sharing available support resources and building trust in confidential communication channels.
Even as a sense of normalcy returns in our practice and our lives, we must be mindful of the aftermath of the pandemic on healthcare providers. Knowing the signs and communicating support options for mental health, including addiction recovery, are critical in our moving forward.
Mike Wilkerson, MD serves as the Corporate Medical Director for Bradford Health Services.
