Substance use disorder in anaesthetists: A personal perspective

Area of Science:

• Anesthesiology
• Addiction Medicine
• Occupational Health

Background:

• Substance use disorder (SUD) is a recognized issue within the anesthesia community, with an incidence of 1-2 per 1000 anesthesiologist-years, potentially increasing due to the opioid epidemic.
• Recognizing SUD in colleagues and intervening is challenging but essential for protecting the individual, peers, and patients.
• The return to clinical practice after SUD treatment is debated, balancing high abstinence rates against relapse risks.

Purpose of the Study:

• To provide a firsthand account of an anesthesiologist's recovery from SUD and return to practice.
• To offer an overview of SUD prevalence, challenges, and management strategies within the field of anesthesiology.
• To discuss the complexities and possibilities of rehabilitation and safe return to anesthesia practice.

Main Methods:

• Personal narrative from a recovered anesthesiologist.
• Review of literature and data on SUD incidence in anesthesiology.
• Discussion of intervention strategies, rehabilitation protocols, and return-to-practice considerations.

Main Results:

• Successful rehabilitation and return to clinical anesthesia practice are achievable with careful planning and support.
• High abstinence rates are observed in anesthesiologists post-treatment, comparable to or exceeding general SUD populations.
• Effective interventions require meticulous planning to safeguard all parties involved.

Conclusions:

• While SUD in anesthesia cannot be entirely prevented, strategies like biometric dispensing, drug analysis, and regular toxicology screening can minimize risks.
• Maintaining professional identity can be a strong motivator for sustained abstinence.
• A supported return to practice, including rigorous monitoring, is feasible for some anesthesiologists recovering from SUD.