Responding to drug and alcohol problems in health professionals, with special reference to Ontario

Concern has been expressed about alcohol and drug problems among health professionals because of the possibility of professional impairment, although there has been no evidence of increased legal suits by patients against such individuals. Alcohol and drug problems among health professionals were recognized but usually ignored by health professional organizations, except for sporadic disciplinary action, until the mid-1970s. At that time, important initiatives took place, particularly in the USA. Approaches developed so far by health professional groups to help their members with alcohol and drug problems can be broadly categorized as either coercive/therapeutic/disciplinary or therapeutic. The former approach is exemplified by US programs for physicians, and the latter by the approach to that profession in Canada. It is suggested that the employee assistance model is an alternative approach that could be adopted by health professionals, and that this model could be expanded to a health promotion/prevention/assistance model. Although there has been significant progress in the development of programs in Ontario to help health professionals with alcohol and drug problems, this development is faltering because of lack of support from health professional organizations.