The New Republic magazine has an excellent article about drug addiction among anaesthetists. It tracks the story of one rising star in the speciality who became addicted and discusses discussing why opioid dependence is still a problem in the field.
It’s probably worth stressing that while anaesthetists have the highest rates of opioid addiction among doctors, the absolute rates are still actually quite low.
A 2002 study found level of drug abuse in the US to be 1.0% among faculty members and 1.6% among residents (junior doctors), and ‘drug abuse’ here doesn’t entail addiction – it just describes illicit use of controlled substances.
However, the increased rates of drug use are certainly cause for concern, this is from a review article on ‘Addiction and Substance Abuse in Anesthesiology’ published last year:
Anesthesiologists (as well as any physician) may suffer from addiction to any number of substances, though addiction to opioids remains the most common. As recently as 2005, the drug of choice for anesthesiologists entering treatment was an opioid, with fentanyl and sufentanil topping the list. Other agents, such as propofol, ketamine, sodium thiopental, lidocaine, nitrous oxide, and the potent volatile anesthetics, are less frequently abused but have documented abuse potential. Alcoholism and other forms of impairment impact anesthesiologists at rates similar to those in other professions.
The New Republic article is an engaging look at this issue that manages to tackle both the human issues and the view from the medical literature.
If you’re interested in the history of anaesthesia, ABC Radio National’s In Conversation recently had a fascinating discussion with historian Stephanie Snow, who’s just written a book on the subject called Blessed Days Of Anaesthesia.
It has loads of intriguing nuggets of information, such as the fact that resistance to the introduction to effective pain killing was bolstered by moral arguments as to the necessity of pain, but also scientific theories about the nervous system that suggested it was essential during operations to keep the body functioning.
A fascinating insight into early thinking about the value of pain.
(28 Dec 2011: updated links – thanks Tom!)