Drug abuse remains a pervasive problem in this country, despite all of the laws written to try and change it. Not only are illegal drugs abused, but also prescription (and even over-the-counter drugs).
It’s perhaps not surprising that a number of studies have found that there is a higher than normal rate of prescription drug abuse amongst doctors. After all, it’s a high-stress profession and doctors generally have easy access to prescription drugs (some doctors have even been caught make extra money by writing prescriptions for addicts).
This is an epidemic in this country, look in your local neighborhoods, prescription clinics are popping up all over the place, even small pharmacy are opening looking to capitalize on the mass addition to pain killers.
Back to the doctors.
Drug abuse, of course, causes impaired judgment. None of us want our doctors to be drunk or on drugs when they examine or treat us. Because of this, programs have been started in a number of places to help doctors recover from drug addiction. Most States have laws in place the require doctors to be in random drug testing pools. In many cases their licenses to practice medicine are suspended. Some hospitals now enforce random testing on employees, including physicians and residents. Smaller clinics may make use of companies like USA Mobile Drug Testing, but most hospitals and clinics currently use their own in house labs.
So is it OK to grade your own test?
You can imagine the liability it must pose, for the hospitals to do their own drug testing. Does the honor system work? Should we take that chance when lives are involved? Ok, I see pre-employment being OK, but post-accident and random testing no way. How do we know that there is no funny business going on, when something goes wrong?
Enough ranting and back to the story.
Random testing is the only way to find drug abusers in our hospitals. Doctors and medical personnel continue to face a challenging environment after rehabilitation and some may well relapse. This places boards in a difficult situation. Some of these doctors may never be able to practice again. Medical personnel who are addicted may steal drugs from hospital pharmacies - but doctors can just write a fake prescription. The most commonly abused drugs are painkillers such as hydrocodone. Unfortunately, there is no legal requirement for doctors and healthcare workers to be regularly screened. When they are, it is because hospitals or clinics have taken it on themselves to make sure their personnel are clean. Even the AMA has no policy on drug testing. However, statistics show that the threat of random tests actually makes doctors less likely to take drugs. This is important as doctors are literally FIVE times more likely than the general population to abuse prescription drugs.
Likely, this is related to the stress of the job and the easy access to painkillers. Other doctors abuse stimulants in order to get through long shifts. One resident wrote himself a prescription for a sedative because he was nervous about a seminar he was giving. Perhaps doctors should not be allowed to write themselves prescriptions - but most addicted doctors could find themselves a coworker willing to do the task for them. Doctors are also more likely to deny they have a problem, simply because they know more about their problem. They think they know enough to avoid addiction or impairment, but there really is no way to do so. Doctors are often so blasé that they will help nurses and other workers get their own ‘stash’. This problem is not limited to the United States - some studies indicate that as many as one in six British doctors have had a substance abuse problem at some point. One young British doctor would use prescription drugs as a hangover remedy...and she was hung over every morning (alcohol abuse is also common amongst doctors).
We need to be able to trust our doctors...and many of them cannot be trusted in the presence of a stash of easily-abusable drugs. Common painkillers are easy to abuse, as are many psychiatric drugs. And, of course, many of these medicines contain the precursors for speed. If doctors cannot be trusted to do this on their own, then random testing, either through the hospital’s own labs or, perhaps better, through an independent mobile drug testing facility is the only answer (after all, if people can’t be trusted not to abuse drugs can they, or their coworkers, be trusted not to hide test results). These doctors need help, for their own sake and the sake of their patients.