In fact, no one really knows the Caring for the Caregiver
How to identify and support a colleague with a substance abuse disorder. BY CECIL A. KING
During my presentation “Deadly Caring: The Ef- fects of Substance Abuse on Perioperative Care Givers and the Support
Needed” at ASCA 2013, April 17–20, in Boston, I will describe the physi- cal, psychosocial and environmental aspects of substance abuse and chemi- cal dependency. I will also discuss the prevalence of these disorders, interven- tion and treatment strategies, re-entry into practice and workplace policies that can assist all those affected when a health care professional is involved.
A 8
2007 survey conducted by the office of Substance Abuse and Mental Health Services Administra- tion (SAMHSA) reported that within the American work force, among em-
ASC FOCUS APRIL 2013
ployees 18 years of age or older, 30 percent smoke tobacco products daily, 8 percent drink alcohol daily and 15 percent have used an illicit drug with- in the past year. In her study published in the Febru-
ary 2007 issue of Critical Care Medi- cine, Marie R. Baldisseri, MD, of the University of Pittsburgh School of Medicine in Pittsburgh, Pennsylvania, estimated that 10–15 percent of health care professionals will misuse drugs or alcohol at some time during their pro- fessional life. In an August 23, 2009, article in The Student Doctor Network, Brian Fingerson, president of the Kentucky Professionals Recovery Network, said that 12–16 percent of pharmacists and other health care professionals have a substance abuse problem.
prevalence of substance abuse among perioperative professionals. Health care professionals abuse benzodiazepines and opiates at a high- er rate than the general population, ac- cording to a 1999 article, “Physician Substance Abuse by Medical Special- ty,” in the Journal of Addictive Dis- eases. Three physician specialties— anesthesia, emergency medicine and psychiatry—have the highest rates of illicit drug abuse, while surgeons have the lowest rate, the article states. Ten to twenty percent of nurses have a substance abuse problem, according to a 1999 article, “Prescription-type Drug Misuse and Workplace Access Among Nurses,” in the Journal of Ad- dictive Diseases. Thirteen percent of those who report the non-medical use of opiate prescriptions meet the crite- ria of abuse or dependence, according to an April 2008 article in Drug and Alcohol Dependence.
Substance Related Disorders Substance abuse is a maladaptive pat- tern of substance use manifested by one or more of the following within a 12-month period, according to the 4th edition of the Diagnostic and Statis- tical Manual (DSM-IV) produced by the American Psychological Associa- tion (APA): 1. failure to fill major role obliga- tions;
2. recurrent use in physically haz- ardous situations;
3. legal problems; and 4. continued use despite social or interpersonal problems caused by the use of the substance. The criteria for substance depen- dence, also according to the DSM- IV, are a maladaptive pattern of use with three or more of the following occurring at any time in the same 12-month period:
The advice and opinions expressed in this article are those of the author and do not represent official Ambulatory Surgery Center Association policy or opinion.
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