[Substance abuse by health personnel]

This paper is a review of the literature on health professionals with substance abuse and it deals with the epidemiology, treatment, and results. A similar study has been carried out on health professionals in Denmark. Very few data are available for this group. The prevalence of substance abuse in health personnel seems to be equal to that in the general population, and from these data it is estimated that 3300 doctors/nurses in Denmark have an active alcohol abuse whereas the prevalence of other drug abuse is not known. The National Board of Health receives 150 new cases a year, in which decisions about specific treatment are made. Not all these cases are about substance abuse. Today, no organised treatment is on offer to health personnel with substance abuse, and they are forced to find their own. Results from abroad indicate that treatment with some degree of monitoring gives better results for health personnel than no monitoring, perhaps because of the risk of losing their authorisation, which is the penalty in this group, if substance abuse continues. From the results of a Danish study, the treatment in Greater Copenhagen seems less effective than the treatment given abroad. It is, therefore, recommended that the treatment of health personnel should be centralised in three or four places in Denmark, each with capacity for 30 outpatients. It is furthermore recommended that inpatient treatment of health personnel in work, which, generally speaking will be that needed in connection with detoxification, takes place in departments with a special interest in treating this kind of patient. Inpatient treatment is furthermore recommended for patients with psychiatric or somatic co-morbidity in addition to the substance abuse, or where repeated attempts at outpatient treatment have been unsuccessful. The estimated need is the possibility of admittance to two psychiatric beds per centre. Lastly, it is recommended that structured treatment in this group of patients should be established in close co-operation with the unions for advisory or legal assistance in the case of early retirement or change of job.