Transcript for the Piece Audio version of The Fundamentals of Impairment-Part 1
Murphy/ Part 1
Troubled Doctors: Addiction and Depression in Medicine
Airdate May 6, 2008
Lead:
Drug and alcohol addiction can be devastating. Healthcare workers are particularly vulnerable because of job stress and easy access to medications.
?I got what you call addiction in the fast lane when I was using the IV opioids, just beginning to use them to being really sick in just about six months, and being hopelessly addicted.?
This Seattle doctor was an anesthesiologist until his drug problems derailed a promising career. He was able to get back on track with the help of an innovative nonprofit called the Washington Physician?s Health Program.
KUOW reporter Patricia Murphy has the first of a three part series on physicians suffering from addiction and depression.
We?ll call him Doctor N. Today he?s a chronic pain physician in recovery, but early into his residency at Seattle?s Virginia Mason hospital he was suffering. The casual drinking that began in college was becoming a problem.
?I had enough tolerance and enough physical dependence that when I couldn?t drink I started having withdrawal symptoms. And this was particularly bothersome because it was on-call overnight in the hospital quite frequently at that time. These nights were very miserable.
The withdrawals were making N sleepless and irritable.
?And it started to cause a lot of problems with staff at the hospital, because I would ? I almost developed somewhat of a reputation as being kind of a hothead and I was reprimanded several times for bad interactions with the nursing staff .?
After being warned by his supervisors about his combative behavior, Dr. N began using opiates to take the edge off. At first, he used Oxycodon, but eventually he started using an anesthesia drug called Fentanyl. It?s 80-times more powerful than Morphine.
We always had a syringe of Fentanyl in our pocket when we were on call that night, in case there was an emergency case, so we wouldn?t have to waste time checking it out; we would have it available. Even then, I didn?t use it immediately. I knew that that was kind of like stepping over a line.
Doctor N knew injecting the Fentanyl was wrong and unethical. He couldn?t bring himself to use intravenously.
So I squirted a few cc?s of the medication up my nose, as if, you know, just like snorting cocaine, I knew it would absorb through my nasal mucus membrane. And it did very well.
After 6 months of addiction Doctor N went from snorting Fentanyl to injecting it. In the end and could barely go an hour without using and started stealing from his patients.
Even though my patients weren?t in actual fact getting this medication, if you looked at my record with checking medicine out it looked like I was quite liberal with administering it to my patients, when in actual fact it was all going to me.
Doctor N?s patients were in unusual post op pain. That baffled the nurses.
By diverting a narcotic medication, Doctor N had committed a felony.
Moreover, he was putting his patients at risk.
Luckily, none of N?s patients suffered any long-term harm from his behavior. But there have been more tragic outcomes.
In a case in Richland ,Washington, a women undergoing routine surgery sustained severe brain damage after her impaired anesthesiologist removed her breathing tube prematurely.
As Doctor N?s addiction to Fentanyl became all-consuming, his behavior became more risky.
I couldn?t check out enough to satisfy my need without drawing attention to myself, and so I started going through the syringe discard buckets on anesthesia carts in the operating room. And that?s how I got caught.
The OR had closed circuit TV. A nurse had watched the whole thing and contacted his residency director who finally confronted him.
?It was kind of like a huge relief. Oh, thank God, the nightmare?s over. I?ll be able to get fixed up and get on with my life. I kind of knew there was treatment for this problem, but I had no idea what it was or what it involved. I just figured they?d send me a way for a couple days, and I?d be good as new.?
In a short time, with the help of The Washington Physicians Health Program, Dr N found himself in an addiction treatment program.
For 20 years, WPHP has worked with hospitals and healthcare facilities to get help to practitioners suffering from addiction and depression. The Medical Director and CEO is Dr. Mick Oreskovich. He says the program?s credibility lies in its 75-percent success rate for its clients in recovery.
?The key thing is that there is a confidential conduit for getting help, as opposed to a report to a disciplinary authority. The second most important part is the tri modal monitoring that we do. We monitor then chemically, we monitor them behaviorally and we monitor them professionally. ?
Through this monitoring, Physicians can gain the program?s endorsement that they?re safe to practice. WPHP is now part of a national study to determine whether its methods can be applied elsewhere.
Part of the WPHP?s mission is to educate hospital staff about the warning signs of substance abuse. Doctor N?s irritable behavior with the nursing staff was a red flag. Oreskovich says healthcare professionals have a hard time accepting help for addiction and depression.
?I think the training of the deep commitment and responsibility of physicians makes it difficult for them to admit that they are powerless over anything. ?
Once they?re in treatment, physicians must begin to overcome that deep denial if they ever hope to return to practice. Patricia Murphy KUOW news.
Announcer tag:
In part 2 of our series tomorrow, we?ll hear how a patient was tragically affected by a doctor?s untreated addiction.
