Doctors and Substance Misuse: Types of Doctors, Types of Problems

Addiction. 1993 May;88(5):655-63. doi: 10.1111/j.1360-0443.1993.tb02078.x.

Abstract

The casenotes of 144 doctors who had received treatment for substance misuse were analysed. There were no differences between general practitioners (n = 61) and hospital doctors (n = 58) in terms of their substance misuse histories or the problems they incurred. Differences emerged between the consultant (n = 24) and the non-consultant (n = 34) grades of hospital doctor. The consultants were older at onset of problematic use (42.6 +/- 8.6 vs. 29.9 +/- 9.8 years); they suffered fewer career problems and misused fewer substances. The most frequent pathways into substance use were personality difficulties (76 subjects, 52.8%) and anxiety or depression (46 subjects, 31.9%). A history of depression (n = 36) was associated with perceived stress at work (p = 0.014), and at home (p = 0.06). Past neurotic disturbances (n = 20) were associated with personality difficulties (p = 0.035), anxiety or depression (p = 0.004), and with an earlier onset of problematic substance use (30.2 +/- 8.3 vs. 36.5 +/- 9.8 years, p = 0.014). Principal components of possible antecedents yielded one major component on which all elements loaded; this was labelled the 'disturbance score'. This score showed a reduction with increasing age of onset of problematic substance use.

MeSH terms

  • Adult
  • Alcoholism / epidemiology*
  • Alcoholism / psychology
  • Alcoholism / rehabilitation
  • Cross-Sectional Studies
  • England / epidemiology
  • Female
  • Humans
  • Illicit Drugs*
  • Incidence
  • Male
  • Medicine / statistics & numerical data
  • Physician Impairment / psychology
  • Physician Impairment / statistics & numerical data*
  • Psychotropic Drugs*
  • Retrospective Studies
  • Specialization
  • Substance-Related Disorders / epidemiology*
  • Substance-Related Disorders / psychology
  • Substance-Related Disorders / rehabilitation

Substances

  • Illicit Drugs
  • Psychotropic Drugs