Warning of drug abuse in resident physicians

Theo kết quả một nghiên cứu hồi cứu thuần tập trên 44.000 BÁC SĨ nội trú gây mê được đào tạo trong khoảng thời gian từ 1975 đến 2009: có 384 (0,86%) bác sĩ khẳng định bị các rối loạn do sử dụng chất gây nghiện (substance use disorder) trong thời gian học nội trú.

Recently, the public was abuzz with news that a doctor committed suicide due to the pressure of work and life, the cause is said to be suicide by intravenous injection. Is the life of a doctor too stressful? How can they overcome the difficulties of everyday life, the pressure of public opinion... to continue to contribute to the cause of people's health care?

By the way, Medscape has an article about the situation of drug abuse among anesthesia residents, which is also a warning to other specialists. Let me summarize it for you to read and ponder.

According to the results of a retrospective cohort study of 44,000 anesthesiology residents trained between 1975 and 2009: 384 (0.86%) physicians confirmed that they had substance use disorders during their residency. Of these, 43% relapsed at least once after being detected and treated. Notably, 28 anesthesiologists participating in the study died during their training, all of these deaths were directly related to substance use disorders.

“With about 6,000 anesthesiologists trained each year, about 20 of them have this problem, and one or two anesthesiology residents die. The number increases with each stage of training,” said David O. Warner, an anesthesiologist at Mayo Clinic Rochester, Minnesota.

Regarding the substances abused, intravenous opioids are the main ones used, but cannabis, alcohol, and prescription narcotics are also noted. The question posed by the authors is: Why do anesthesia residents become addicted to substances? Is it because of pain, or is it because the residency is too stressful with the pressure of work, school, and work environment? Addiction is a clinical condition characterized by denial and avoidance, so getting an honest answer as to why they use substances is difficult. Of course, some of them use substances to relieve pain, but stress is probably easier to explain.

According to Dr. Thomas McLellan, Director of the Philadelphia Institute for Treatment Research, Pennsylvania: “… The small percentage of anesthesia residents using substances does not surprise me because the study only focused on residents, while graduate doctors and nurse anesthetists are the higher risk group because they have easier access to addictive substances.”

According to Professor Warner, this is a wake-up call for other specialties, because there is no research data on this issue in other specialized areas. In particular, family doctors are also a large group and are not an exception.

Dr. McLellan added: “… Substance addiction is not a moral failure, it is a chronic disease that can respond to treatment. Our solution is to be vigilant, detect early to intervene, treat promptly and continue to monitor and manage to avoid relapse.”

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