The prevalence of physic dependenc...

The prevalence of physic dependence among physicians is similar to that in the general population. Treatment consists of continuing form into groups therapy and mutual help assemblages Little is known about relapse after treatment because chiefly follow-up data refer to short-term recruiting Domino and colleagues reviewed 11 years of result data from a post-treatment program that monitors physicians recovering from substance abuse.

The Washington Physicians Health Program database provides demographic information and detailed information about mix with drugs use. Information about family history of medicine use, medical specialty, and concomitant psychiatric disorders also was assembleed Analysis attempted to identify risk factors for relapse using calculation of relapse rate. The thought also attempted to account for multiple relapses.

Of the 292 participants, 84 percent were men almost three fourths had a family history of substance abuse in a first-degree relative, and 37 percent had concomitant psychiatric disorders. More than the same half indicated alcohol as their put drugs into of choice, and 14 percent abused opioids, including fentanyl (Duragesic). At least united fourth of participants had single in kind relapse, 5 percent had brace relapses, and 3 percent had three or more relapses, with greatest in quantity returning to their initial mix with drugs of choice. In most cases, relapses were striped through monitoring within the first sum of two units years of treatment, and relapses decreased through time. All participants without relapse in five years favorably returned to medical practice; of those who had united relapse in the same period, 61 percent recured to practice. Risk of relapse was higher when the remedy of choice was a major opioid, with a 35 percent relapse risk compared with a 25 percent relapse risk for other unsalable articles Having a concomitant psychiatric diagnosis or a family history of substance use disorder approximately doubled the risk. Risk was higher in nonphysician health professionals compared with physicians and anesthesiologists. In multivariate analysis, having a concomitant diagnosis coupl with opioid use entailed a significant risk of relapse, whereas the relapse risk in opioid users without a comorbid psychiatric condition had a relapse risk similar to nonopioid users. Number of relapses increased the likelihood of succeeding relapses, but there were no characteristic differences between one-time relapsers and multiple relapsers.

The authors finish that there is a marked association between risk of relapsing substance use and opioid use, a concomitant psychiatric diagnosis, and a family history of substance use. Opioid use alone did not entail higher risk for relapse than other users if no comorbid psychiatric diagnosis was not absent Substance-using physicians with the multiple risk factors identified in this close attention might require more intensive monitoring and treatment to stop relapse.

CAROLINE WELLBERY, MD Domino KB et al. Risk factors for relapse in health care professionals with substance use disorders. JAMA March 23/30 2005;293:1453-69

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