Barriers to seeking help for physicians with substance use disorder: A review

• Published in: Drug and alcohol dependence 2019-06, Vol.199, p.116-121
• Main Authors: Vayr, Flora, Herin, Fabrice, Jullian, Benedicte, Soulat, Jean Marc, Franchitto, Nicolas
• Format: Article
• Language: English
• Subjects: Addictions; Barriers; Burnout; Comorbidity; Denial; Drug abuse; Drug addiction; Drugs; Fear; Fear & phobias; Female; Humans; Impaired physician; Life Sciences; Male; Mandatory reporting; Medical diagnosis; Medical personnel; Medical students; Occupational health; Occupational stress; Patient Acceptance of Health Care - psychology; Physicians; Physicians - psychology; Psychiatric comorbidity; Risk analysis; Risk Factors; Self Medication - adverse effects; Self Medication - psychology; Self-medication; Social Stigma; Stigma; Substance use; Substance use disorder; Substance-Related Disorders - epidemiology; Substance-Related Disorders - psychology; Substance-Related Disorders - therapy
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2019.04.004

•Substance use disorder affects as much as 8–15% of physicians.•Potential barriers prevent impaired physicians from seeking help.•Priority should be given to educating physicians to reduce the impact of the stigma. Substance use disorders (SUD) might concern as many as 8–15% of physicians. Previous studies suggest that self-diagnosis and self-medication are common practices among physicians. The aim of this review was to identify if barriers to seeking help and medical care for impaired physicians exist. We also aimed at characterizing the nature of these barriers. The review included scientific papers published on the MEDLINE and PsychINFO databases between January 2000 and September 2018. The inclusion criteria were: (i) articles that focused on SUD in physicians. The exclusion criteria were: (i) no mention of SUD; (ii) no mention of barriers to seeking help; (iii) articles focused on burn-out and work-related stress; (iv) articles focused on risk factors or treatments for SUD; (v) articles focused on psychiatric comorbidities and (vi) those focused on other professionals. Potential barriers to seeking help that were identified for impaired physicians with SUD included denial of the disease and of loss of performance, fear of stigma, psychiatric comorbidities, fear of familial/social/professional and economic consequences and a lack of knowledge. Different barriers to seeking help could be identified. Priority should be given to educating medical students to ameliorate this. Increased awareness should reduce the stigma, which, even nowadays, still prevents some physicians from seeking help.