Abuse of Prescription Drugs by Medical Practitioners

Introduction

What are the significant effects of prescription drug abuse by medical professionals? Medical practitioners’ ease of access and ability to self-subscribe drugs has exposed drug abuse among this category. A survey carried out in the 1990s indicated that the practitioners suffer drug and substance abuse at the same rate as the rest of the population i.e. 8-12%. It was estimated by the National Survey on Drug Use and Health that the number of Americans who used pain relievers non-medically by 2005 went up to 32.7 million from 29.6 million in 2002. according to the American Medical Association report, a proportion of the doctors who would likely abuse drugs or alcohol was 15% which is similar to that of the general public (Blythe). In 2006, more than 35 doctors of those who were disciplined by the Missouri medical board (seventy one) had drugs or alcohol-related charges. Self-dosage has also been reported. It is reported that one doctor had collapsed at the hospital after injecting himself with tranquilizers. This is according to a survey of 9600 doctors. In an addiction rehabilitation program in CenterPointe Hospital in St. Charles, two pharmacists, six doctors, and sixteen nurses have been treated which means prescription drugs are a problem, at times to the people who are supposed to administer them to patients. There is the confidence in practitioners that they will control the drugs since they know much about them, but when addiction is already realized, chances of self-help may become slimmer. According to David Ohlms, who is a medical director of chemical dependency at the aforementioned hospital, doctors mostly addict to sleeping pills and pain killers (Blythe).

The most abused prescription drugs around the United States and around the world are the Opioids-often used to treat pain, the drugs used for treating anxiety and sleep disorders-CNS depressants, and Stimulants used to treat obesity, narcolepsy and ADHD- attention-deficit hyperactivity disorder.

An estimated 4 million Americans were found to be under usage of prescriptions which were for non-medical purposes in 1999, about 2.5 million were under dosage of pain relievers. Opioids refer to the drugs administered to relieve pain, for example after surgery. The opioids drugs attach themselves to opioids receptors blocking the conveyance of pain messages to the brain. Opioid receptors are found in the brain, gastrointestinal tract, and the spinal cord. They may also bring about constipation, drowsiness, and depressed respiration. Continual usage of these types of drugs may result in the body being tolerant of the drugs, and if the patient withdraws from usage, pain may be experienced in bone, muscle, and the patient may vomit, diarrhea, experience involuntary movement of legs, experience goosebumps and cold flushes. Among the resulting effects of usage of opioids is respiratory depression which may lead to death. Another risk with these drugs is the use with other substances such as alcohol which may cause central nervous system depression (“Prescription Drug Addiction”). Prescribed drug addiction occurs mainly in people with initially present history of psychological problems or abuse of substances in the past.

An example of a case where a nurse was reported to have entered a patient’s name so as to acquire Vicodin pain killers for her own use, and subsequent confession by the nurse that she had stolen this type of drug before may reveal the fact that medical practitioners are not free from prescription drug usage and addiction. Drugs acquired by choice may be more dangerous, and therefore medical practi9tioners are at a risk of over-usage of self-prescribed drugs. In Cuyahoga, 10 nurses (in unrelated incidences) who had stolen prescription drugs were indicted. Most of the disciplinary actions taken against the medical practitioners involve drugs. The numbers may not be small. For example, every year sees 40-70 nurses indicted in Cuyahoga County for cases of stealing felony drugs. The use of painkiller electronic dispensers has been reported among the nurses, and many of the ones indicted were discovered by auditing the machine, which allows tracking of drug orders, inventories, and withdrawals. This type of ATMs for the drugs like Oxycontin and Percocet make it easy to detect and prosecute drug theft. Such as the case of Dr. Christopher Hart, whose license was revoked in 2004 for taking Vicodin from the place of work for a second time may not tell a different story. He had been treated, in addition to a five-year drug testing and AA meetings adherence requirement. Reportedly, he thought he would manage since he was a professional and stealing 15 pills a day made him feel euphoric according to him. The reasons for more usage of prescription drugs by the general population may be attributed to the following (Maxwell);

  • Their being cheap
  • Their ease of availability-available everywhere and easy to acquire
  • They are not illegal drugs
  • They are of lesser side effects than street drugs
  • Can aid studying among teens and students
  • Easy to purchase over the internet
  • Less shame attached to their usage

Reasons for use of prescription drugs among the medical profession may be attributed to the kind of pressure they undergo during their practice. Although the nature of their job being taxing cannot be a satisfactory excuse for using these medications, there is a need to ensure that the personnel is not overworked and ensure that they are having time to rest and socialize to relieve any negative thoughts. Cases of shortage of professions like doctors in some countries cannot be overemphasized. This is due to the demanding nature of the practice and academic requirements. Resulting smaller number of doctors in proportion to the patient may result in ti8ght schedules for doctors who a times may be required to working all day long and night since patients need to be attended to save life. In some countries where there is understaffing of the medical professionals, it may be observed that the same personnel operate at different hospitals and/or a times also teach at medical colleges. The law may also not be tough on such practice. The result is that doctors may be overstretched and may under stress and hence may find themselves with the need to take such medications so as to keep with these schedules.

Consequences of drug abuse among health practitioners

Health practitioners who abuse prescription drugs may affect their own families and friends, in addition to affecting the patients. The following are the possible consequences-personal or non-personal, of drug abuse (“Drug abuse Among Nurses”).

  • Death of the patient leading to the cut of the number of professionals available, e.g. nurse shortage in hospitals.
  • A medical practitioner who is under abuse of prescription drugs may transmit the problem by providing patient under-care, commission of medication errors, and mistreatment of the patient.
  • Loss of jobs, time and hence reduced wages, among other results.

Control of prescription drug abuse

Prescription drug abuse among the medical practitioners occurs for the same reasons it occurs among other people. Causes include stress due to jobs which lead to drug self-prescription, money issues, trauma, anxiety and depression, among other causes. One of the key steps to cutting abuse of prescribed drugs is the identification of the existence of the problem. Some of the simple questions physicians can help determine whether they are under unusual usage of drugs is whether they have/had a feeling of need to cut down their usage of the types of drugs, have been remorseful about their usage of prescribed drugs, whether other people made remarks on their unusual usage of prescribed drugs, and determining whether they ever used drugs as a way to ‘get on’ or calm down (Ewing; cited “Prescription Drug Addiction”). Recognition of the problem can be followed with a strategy for recovery and seeking treatment when necessary.

Behavioral means or pharmaceutical means can be applied to cure addiction of prescription drugs in an attempt to control their abuse. These are applicable not only to the medical practitioners but to all people. The behavioral means of controlling of addiction to prescription drugs involves teaching people to avoid relapse, situations that would require drug usage, handling cravings, and to function without drugs. Counseling-group or family-contingency management, cognitive-behavioral therapies are behavioral corrections that may be administered to medical practitioners who are abusing drugs. Drug cravings, withdrawal symptoms, and overdose may be treated through a pharmacological approach.

It has been reported that oncology, rehabilitation, and psychiatric nurses abuse prescription drugs more than other specialties. It is important that hospitals stress the need for setting up peer groups where nurses and other medical practitioners will learn the effects of prescription drugs abuse and how to control it. Besides, retraining and training of the staff through seminars and group-works on the subject matter may yield positive results.

Initiating and maintaining a medical board recovery program which would habit doctors who are recovering from usage of prescription drugs may help. It has been reported that long term sobriety may be attained by 80-90% of doctors who go through these recovery programs, according to Paran, an addiction specialist at Case Western Reserve University. The rehabilitation programs should be adjusted to be stringent in order to take care of all the professionals (Harlan).

The current or recent past trend seems not to have over-treated the fact that medical practitioners are normal people who are endangered to use of prescription drugs like any other person. Usually, the trend has been harsh for them, as if they were not prone. There is a need to help the practitioners get over drug abuse such as prescription drugs instead of putting up a trend that will only make them use the drugs secretly since the punishments are severe. Instead, the government should boost up programs that will assists practitioners reduce the risk of using drugs, such as stressful schedules where there are understaffed hospitals, such as the case with the United States. As a result of understaffing, making doctors and nurses work compulsory overtime and having little time for resting may be seen as factors contributing to higher levels of prescription drug addiction as a means to boost their alertness, manage stress and cope up with tight schedules. There has been, for example, a continued shortage of nurses which experts projected would continue to occur in the United States (US Bureau of Statistics; and “Recent reports”) and even shortage of up to a half a million by 2025 according to.

In cases of understaffing, nurses being forced to work overtime may lead to compromise in the service quality, rushed services, and unsafe practices by the nurses (“American Nurses Association Addresses Nursing Shortage at Senate Subcommittee Hearing”).

There is need to ensure that the ergonomic needs of nurses are met to assure nurses of their health according to Buerhaus, Stranger, and Auerbach (278-284), who also indicate that by 2010, 40% of working registered nurses in the United States will be more than 50 years. The danger for aging workforce may be implicated by data that show that most people who abuse or addict to prescription drugs is those who are elderly. Thus the problem may be expected to increase or remain if the work force of the whole medical practitioner group is aged. Solving the problem of understaffing, which a time occur as a result of a small number of recruited staff and those quitting the profession may be tied to some extent to the problem of drug addiction. This is because it may cause the smaller number of medical practitioners to be burdened.

According to the aforementioned author, there is need to boost men’s enrolment to nursing by removal of barriers, allow assistance of unlicensed personnel to assist nurses in patient caretaking, apply technology to enable better usage of the registered nurses and among other solutions to curb the shortage of nurses in the United States. The government should also solve such and other needs among other health professionals too.

Conclusion

In conclusion, there is evidence of addiction to prescription drugs among medical practitioners. Medical practitioners are also prone to use of prescription drugs like any other person due to the common reasons of stress, trauma, and financial-related reasons, among other reasons. In addition to these, doctors and other medical practitioners may find themselves using the drugs due to their easy access and a self-confidence of knowledge on drugs or easy reach to help. The consequences of addiction to prescription drugs may include death of the victim, patient mistreatment and suffering family and friends. The government should focus on improving the health of nurses and other practitioners to solve the problem.

Work Cited

  1. “American Nurses Association Addresses Nursing Shortage at Senate Subcommittee Hearing”.
  2. Blythe Bernhard. “Doctors, nurses aren’t immune to drug abuse”. 2008.
  3. Buerhaus, P., Stranger, D., and Auerbach, D. Policy Responses to an Aging Registered Nurse Workforce (2000). Nursing Economics, Vol.18, 6, pp. 278-284
  4. Ewing, J.A. “Detecting Alcoholism: The CAGE Questionnaire.” Journal of the American Medical Association 252(14):1905-1907, 1984
  5. Halan Spector/The Plain Dealer. Prescription drug abuse vexes the medical profession. Web.
  6. Prescription Drug Addiction”. 
  7. “Recent reports”, 2008.