Recreational drug preference linked to medical speciality

Following our piece on several cases of drug addiction in anaesthetists, I just found some interesting studies on how recreational drug preference varies between medical specialities. It seems working in psychiatry and emergency medicine is linked to the highest rates of drug use, with surgeons having some of the lowest levels.

This study seems to be the most comprehensive on doctors of all levels of seniority:

Emergency medicine physicians used more illicit drugs. Psychiatrists used more benzodiazepines. Comparatively, pediatricians had overall low rates of use, as did surgeons, except for tobacco smoking. Anesthesiologists had higher use only for major opiates. Self-reported substance abuse and dependence were at highest levels among psychiatrists and emergency physicians, and lowest among surgeons. With evidence from studies such as this one, a specialty can organize prevention programs to address patterns of substance use specific to that specialty, the specialty characteristics of its members, and their unique practice environments that may contribute risk of substance abuse and dependence.

A 1992 study looked at exactly the same thing in junior doctors, and again found similar results – psychiatrists and emergency doctors tended to be more likely to use drugs, while surgeons were among the least likely:

Emergency medicine and psychiatry residents showed higher rates of substance use than residents in other specialties. Emergency medicine residents reported more current use of cocaine and marijuana, and psychiatry residents reported more current use of benzodiazepines and marijuana. Contrary to recent concerns, anesthesiology residents did not have high rates of substance use. Family/general practice, internal medicine, and obstetrics/gynecology were not among the higher or lower use groups for most substances. Surgeons had lower rates of substance use except for alcohol. Pediatric and pathology residents were least likely to be substance users.

A similar study on nurses was conducted by the same team a couple of years earlier and found similar results:

As hypothesized, rates varied greatly by speciality. Oncology nurses reported the highest past-year prevalence for all substances combined (42%), followed by psychiatry (40%) and emergency and adult critical care (both 38%).

Emergency and pediatric critical care nurses had the highest prevalence of marijuana / cocaine use (7%), followed by adult critical care nurses (6%). Prescription-type drug use was less varied across specialties: those with the highest prevalence of use were oncology, rehabilitation, and psychiatry. For cigarette smoking, psychiatry had the highest prevalence (23%), followed by emergency and gerontology (both 18%). Pediatric critical care nurses were least likely to smoke (8%). Binge drinking was high among oncology, emergency, and adult critical care nurses.

Link to abstract of recreational drug preference in doctors study.
Link to full text of drugs in junior doctors study.
Link to PubMed entry for same.
Link to full text of study on nurses.
Link to PubMed entry for same.

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