How common is addiction in healthcare-Addressing Specialties risks
Physicians treated for addiction have recently become the focus of high quality, evidence based outcome research published in peer-reviewed journals. The results of this research indicate that the treatment of physicians is profoundly effective when properly executed. As a policy there are three important areas of addiction among healthcare and other licensed professionals, including issues related to stigma, the effective response to the problem of addiction among professionals, and the interrelation and integration of medical, legal, and sociological issues regarding addiction in this particular population.
Several factors are involved in the etiological differences of addiction as it manifests in the special population of healthcare and other licensed professionals.
First, one group of professionals (healthcare providers) have greater access to addictive drugs in their workplace, which can accelerate and complicate the onset and progression of the disease.
Secondly, healthcare professional training creates a level of comfort and an associated false sense of immunity to the dangers of drug use. Having technical knowledge about the pharmacology of drugs does not protect susceptible individuals from becoming addicted to such drugs and, in fact, may actually predispose susceptibility.
Thirdly, all healthcare and other licensed professionals with addictive illness face tremendous prejudice based on stigma and fear which make them hesitant to admit a problem or seek assistance. Lastly and importantly, as with other safety-sensitive occupations, healthcare and other licensed professionals with untreated, potentially impairing conditions have the potential to place the public at risk.
Many individuals and agencies play a role in the care and coordination of the addicted healthcare and other licensed professionals. For the purposes of this article, we have focused on four critical entities:
- The population of healthcare and other licensed professionals with the disease of addiction.
- The specialty treatment programs where these persons receive clinical care.
- The various Physicians / Professionals Health Programs (PHPs) which provide continuing care monitoring and earned advocacy.
- State-specific license agencies and other comparable regulatory agencies.
These entities, as defined, have an interrelated and often symbiotic role in both the successful rehabilitation and recovery of the addicted professional, and the safety and welfare of the public.
How common is addiction in healthcare-The Addicted Professional
The disease of addiction produces characteristic behaviors. The characteristics and circumstances of the patient who is, himself or herself, a professional are unique. These issues be considered and managed during treatment and post-treatment recovery. These policies address physician patients who are part of a professional cohort; but include other licensed professionals including, but not limited to, nurses, physician assistants, pharmacists, psychologists, commercial pilots, attorneys, law enforcement officials, as well as any cohort who provides a public service that could impact the public health, safety, and welfare. Each of these groups is unique in the perception of their disease, their experience of addiction-induced shame, and the necessary coping skills to ensure successful long-term recovery.
Some of these professional groups share strong similarities; however, each specific group should be treated by providers knowledgeable, skilled and experienced in understanding the distinctive educational background, psychological characteristics, work environment, professional culture, social factors, and specific licensure and regulatory agency processes related to each particular cohort of addiction treatment recipients.
How common is addiction in healthcare-Addiction Treatment Programs for Healthcare (ATPs)
Addiction Treatment Programs for healthcare and other licensed professionals specialize in the diagnosis and treatment of addictive and/or mental illnesses in healthcare and other licensed professionals. These clinical programs possess expertise in dealing with issues specific to these populations of ill individuals; some ATPs have expertise in one or more subjects of professionals. ATPs provide a multidisciplinary spectrum of therapeutic services, addressing the biologic, psychosocial, family, and spiritual components of these disease states.
One important element in specialized Addiction Treatment Programs is the presence of a cohort of like-professionals. This peer relating during treatment decreases the isolation and enhances the interdependent learning necessary for effective treatment. ATPs for professionals have extensive experience with and knowledge of the stress and triggers in the work and home environment specific to the professional cohort being treated. This information is used to focus the treatment on cohort-specific issues, encourages reintegration into a healthy home and work environment, and ultimately promotes a sustained successful recovery. The most comprehensive programs manage multiple psychiatric diseases, complex medical conditions, psychological co-morbidity along with a broad spectrum of addictive disorders.
Many facilities that treat addicted professionals provide comprehensive evaluation services as well. Some evaluation programs are organized as separate entities from ATPs, while others are integrated with treatment facilities. Evaluation centers must exhibit a proven track record in understanding the complex multifunctional and insidious nature of addiction among healthcare and other licensed professionals. They should utilize a multidisciplinary team of individuals with specific expertise in distinct but interrelated specialties.
How common is addiction in healthcare-Professionals Health Programs (PHPs)
A Professionals Health Program has mutually symbiotic dual roles of enhancing public safety and facilitating the successful rehabilitation and practice re-entry of healthcare and other licensed professionals with potentially impairing medical conditions. Professionals Health Programs (PHPs) provide a confidential conduit for ill professionals to access a comprehensive evaluation and any necessary subsequent treatment.
When a professional with a potentially impairing illness becomes involved with a Professionals Health Program (PHP) and no harm to the public has been identified, he or she is ideally enrolled in an alternative pathway to professional discipline. PHPs provide the availability of a non-disciplinary alternative with rehabilitation and accountability being emphasized, facilitated, and carefully documented over time. The PHPs continuous, skilled and documented monitoring of the professionals recovery status and associated earned advocacy further promotes the public safety.
PHPs are exceptionally distinct in their ability to provide early identification, intervention, and referral for evaluation and/or treatment. They also conduct three types of post-treatment monitoring: behavioral, chemical, and work-site evaluations. Their success is largely attributable to this tri-partite model of recovery monitoring. The intervention, referral and post-treatment monitoring services offered by PHP’s are generally conceptualized as being distinct from the clinical services offered by ATPs.
PHPs educate the medical community about addiction among professionals, the risks of addiction in professionals and the recognition of the subtle signs and symptoms of addiction in the workplace. Such education and prevention services further enhance public safety by encouraging earlier detection and referral to treatment when appropriate.
How common is addiction in healthcare-Regulatory Agencies (RAs)
These are agencies of state government charged with credentialing and granting licenses to professionals and assuring to the public at large that the conduct of the professional meets professional and statutory standards. State statutes mandate the regulation of selected professions to ensure the delivery of quality healthcare or other services necessary to the public health, safety, and welfare. They investigate the practice of licensees and have authority to address those who violate the state’s professional practice acts or comparable legislation. Their primary mission is to protect the public.
Addiction rehabilitation requires an understanding of the inter-organizational complexities along with associated expertise in the interrelated management of addicted professionals to the benefit of the public we serve. This understanding of addiction rehabilitation among professionals facilitates the interaction by and between Addiction Treatment Programs, Regulatory Agencies, and the Professionals Health Programs.
How common is addiction in healthcare-Addressing Specialties risks
