I have just returned from my hols and a colleague advises that there was quite a bit on this topic last week in the press and on the telly regarding the high levels of "addictive disease" amongst Doctors(his words not mine)I cannot find anything here,can anyone point me in the right direction please.

I didn't catch this coverage. However there is a section on addicted professionals (mostly about doctors) in the new RCGP guide to the management of substance misuse in primary care, edited by Clare Gerada.

In practice these cases are often dealt with by the sick doctor service. My father used to work for this and at least half the work was drug or alcohol related (usually alcohol). Statstics from a few years ago showed doctors to have the second highest rate of liver cirrhosis of any profession (after publicans). In terms of the addicts index (when irt existed) until the 1960's doctors were the largest represented group, since then there have been similar numbers of addicted doctors but the overall percentage has obviously dramatically decreased.

Its likely that changes to how addicted doctors are handled are likely to come out of the Shipman report.

However basically it is nothing new and crops up every so often. Before Shipman the most famously opiate dependent Doctor was Clive Froggett who was Margaret Thatchers GP adviser and in his much publicised anexcdotes admitted to injecting diamorphine in downing street toilets.

jim

Remeber the old saying an alcoholic is someone that drinks more than a gp ( He says on lap top in front garden with a fag and pint of stronbow)

it's interesting that it always does seem to be about doctors. possibly because the profession has recognised the size of the problem and also realised that it makes more sense to try and rehabilitate expensive docs.........anecdotally doctors who do get treatment do well. but what about nurses? my impression is that the nursing powers-that-be don't really want to know, and that addicted nurses tend to be moved around or sacked rather than offered help. i.e. punished instead of treated. or everyone turns a blind eye........but of course given the greater number of nurses then the size of the problem is potentially huge so addressing it would cost......

Hi all, I can always remember the doc's in cowboy films were always bladdered before taking out the bullets with a bowie knife and a slug each of the fire water....the issue for nurses is that the regulatory body (NMC) isn't there to support nurses just punish them as one poster mentioned because they are "protecting the public", which is interesting because the doctor is often the person who decides on diagnosis, type of treatment given and the nurses issue and monitor the effects... surely protection needs to begin at the start of the process?? May be a double standard there? Also, medics are allowed to be rehabilitated with a day course or two, shadow another doctor until better, the nurse is looking in the job centre trying to think of a new career.

I recall one consultant with alcohol problems who was a patient many yjears ago - he got free care at a private clinic under an arrangement with nhs occupational health. I don't know if that sort of arrangement is the norm though.
Agree doesn't seem fair if nurses and docs being treated differently, however seems the rehabilitative/supportive route makes a lot more sense, us health professionals are far too expensive to train and thin on the ground to be dispensed with so lightly!

susi

the ones i know done rehab and then opened up rehabs

short is the pain, long is the adornement

Please dont think I am advertising services, but our clinic sees mainly addicted professionals.
We see doctors, nurses, pharmacists, vets, and anyone who feels unable to approach their local services for help.
We felt this was one of the most underprivilidged and unrepresented groups of drug users in society.
There are plenty of services for Jo public with drop ins and groups, but none for this client group who have very specialised and undermet needs.
We run a private clinic based on the Isle of Wight and also offer Naltrexone implants.
We are registered with the Healthcare Commission.

Since the rapid expansion of services for drug dependency now include ex-service users to a greater extent than ever, this is now another group who may suffer discrimination.

They are statistically more likely to develop drug problems by relapsing than staff with no history of drug problems. How are they to access effective and confidential treatment that does not involve their colleagues?

Some years ago had a client in clinic who was a drug worker in another town, who felt he could not disclose this to his employer as he did not trust their confidentiality. He was off sick for several months when he relapsed but eventually went back to work whilst in treatment, all the time concealing this from his employer.

This in unacceptable to all parties, but he felt he had little option. If he had resided in the town in which he worked he may not have come for treatment until things had deteriorated further, if he came at all.

I am not sure to what extent services have developed effective and confidential systems for caring for 'their own'. Most drug workers will not be able to access the services medics can use when they fall.

Has anyone a good example of effective and fully assured confidential treatment provision for staff? It has to be one that is credible for workers, who know all the leaky holes that systems have.

this is a topic dear to my heart...........i went through treatment ten years ago and i know we're not to talk about personal treatment issues but i still have some extremely strong views about the way i was managed. i wasn't reported to the GMC although i probably should have been, not that i would have been too pleased at the time.........i actually had to make the diagnosis myself as the psych i was sent to see managed to miss a barn-door case of alcoholism.........only the treatment centre seemed to have the foggiest idea what to do with me, and i remember the huge sense of relief at being somewhere where they understood what was wrong with me. recently i've been nosing around trying to find out what help there is nowadays for people locally.....it all still seems to be a bit of a mish-mash and shrouded in secrecy and shame, but they've certainly got better at picking up troubled medical students and getting them help before they qualify. one thing i do feel needs looking at is help for the colleagues.......my treatment centre ran a family programme, and all the signs are that if the family gets help too the chances of a successful outcome are much higher.........but my GP partner got no help or support at all. like most people in that situation she was angry, hurt and suspicious......not to mention humiliated that the diagnosis had been staring her in the face and she hadn't seen it........
.......i could go on but i won't......if you're worried about yourself or a colleague/friend/family member at any time i'm happy to chat, catkin19@blueyonder.co.uk.......

We have seen several Drs & Nurses with alcohol problems through our acute service here in Harrogate (not D5). Some are insurence funded (Drs) but most are funded by their NHS employer on the basis that it would not be helpfull to provide a tier 4 service to a member of staff who may be leading a team in the same hospital they were treated at a few weeks earlier.
The other service I am aware of is The Doctors & Dentists service via (I think) Birdsgrove House in Derbyshire which works to the Minnasotta model.

underneath the fear of retribution and the catchy catchy junkie city posses we have bundles of drug dependent workers/profesionals

One of the drug services I worked in 3 quarters of the workers were either on anti depressants, bundles of femenax/nurofen plus or out and out coke/e's weekend party animals and there is the drinkers....

This message has been edited. Last edited by: will-C,

When the british system started most of the patients were addicted professionals,the idea was that they could be cured and hence no more addict problems, this was well before there was a drugs culture and drugs became popular.Funny though when an addicted doctor comes to light they never choose Methadone as their drug of choice,nearly always diamorphine wonder why?

a lot of that is not really true. Well the bit about most patients being addicted professionals until the 1960s is. However they were very often 'maintained' on diamorphine (methadone wasn't used in those days), rather than 'cured', using the rolleston recommendation (1926) that it should be prescribed in this way to 'bona fide addicts' who were unable to give up. There is apparently the same rate of opiate addicted doctors now as there was then but they are a vastly smaller percentage. Those that are usually have to give up if they want to keep their medical registration. I have never heard of a doctor getting diamorphine (or methadone for that matter). The fact that they would normally access private treatment pretty much rules this out as the home office does not give diamorphine licenses to private prescribers.

there is of course the possibility that they can fraudulently obtain it for themselves (famously Clive Froggett) but this is their own way of maintaining an illegal habit.

This message has been edited. Last edited by: Jim Barnard,

i theory opiates/benzos, in my opinion, would be the drugs of choice to be abused by medical professionals as opposed to alcohol as they of all people would know that there would be less physical damage to the body than alcohol abuse.

that maybe the logic Drew but I'm afraid alcohol is stillt he drug of choice

Drew, you are quite right. I explain to people that pharmaceutical heroin does people no physical harm at all, as far as we can tell. certainly far far better for you than alcohol or cigarettes or cream cakes.

poeple look at me as though i am mad (which I well may be). Of course unfortunately (or maybe fortunately) heroin does have a lot of other costs in our society, even if it leaves your liver and lungs undamaged.

there is of course the possibility that they can fraudulently obtain it for themselves (famously Clive Froggett) but this is their own way of maintaining an illegal habit.[/QUOTE]

that is what i was refering to,as you say a doctor is not going to go to a clinic for help so until they have come to terms with their addiction fraud is the way they go

quote:

Originally posted by judith yates:
Drew, you are quite right. I explain to people that pharmaceutical heroin does people no physical harm at all, as far as we can tell. certainly far far better for you than alcohol or cigarettes or cream cakes.

.

somewhere i was reading that an addict can take about five times their dose of diamorphine and not overdose and that most overdoses are caused by adulterants such as quinine,barbs,

ps i love all of judith yates`s posts,if all professionals were so keyed up life would be a lot better,history will out.

Judith,
You may well be right, but i'm not switching my fags and booze for Diamorphine, even if it made Friday evening surgery just drift along.