#42 A support group for doctors with substance use issues
12 December 2018
One evening a week in an inner city location a group of doctors sit down together and talk about recovery from drug problems. They are part of ‘Caduceus’ – a Victorian Doctors Health Program (VDHP) support group for doctors with substance use issues.
Alcohol and other drug use is no less prevalent in doctors and medical students than in the general population – and being a drug addicted medical practitioner comes with its own unique problems. Frequently the shame, guilt and remorse that is felt by a doctor with a drug problem is a massive barrier to them accessing treatment. This is exacerbated by a fear of possible consequences of disclosure, followed by a tendency to self-treat. Sadly, doctors have died in their attempt to conceal their secret.
The VDHP views substance abuse and dependence as a disease/health issue. High quality treatment is readily available and the prognosis for an addicted doctor who participates in treatment programs is excellent. American and Canadian figures suggest over 90 per cent have successful outcomes and our experience over the years mirrors this.
When a doctor phones in reporting problems with substance use we urge them to come in and talk with us. Our approach is usually to implement a comprehensive treatment and recovery program which may entail referral to a GP and addiction medicine specialist, possible referral to a psychologist or psychiatrist, the commencement of chemical monitoring and regular attendance at Caduceus.
While the weekly numbers at Caduceus fluctuates, there can be anywhere up to 12 participants at each group. As well as providing general support and an opportunity to learn from others who have had similar problems, participants benefit from discussions around the specific challenges of having a drug addiction as a member of the medical profession. While Caduceus is not a 12 step program, some of the participants incorporate Alcoholics Anonymous and/or Narcotics Anonymous into their recovery activities.
VDHP regards Caduceus as an integral part of our case management and monitoring program. Some participants, valuing the ongoing support, continue to attend Caduceus long after their case management has finished. Most of the doctors who attend the group say it has been one of the most important aspects of their recovery program. In addition to helping alleviate feelings of isolation and seclusion, this unique group offers a supportive, non-judgmental, understanding environment where experiences can be shared and mutual support is offered.
I co-authored a qualitative research paper that asked Caduceus participants to complete an anonymous survey regarding their attitudes towards the group and its role in their recovery. Respondents overwhelmingly valued the group, seeing it as an integral and essential part of their recovery and on-going health. The following is just some of the feedback from doctors:
“Very apprehensive at first but then, realising we all had the same problems, I felt relieved and free to talk of my experiences.”
“Although an addict is an addict, I do believe that doctors share common unique issues and a place to meet together is vital.”
“It gives everyone an opportunity to share their experience in a safe environment and allows you to see how others are tackling their addiction, thus allowing you to develop your own recovery program and strategy.”
“Recovery requires life-long management and Caduceus gives me a fantastic opportunity to maintain my recovery and help others do the same.”
“Saved my life, family and work.”
During my years at the VDHP, I have seen many doctors with substance use problems. While the substance of choice varies (the more common ones include alcohol, pethidine, benzodiazepines, cocaine, heroin, methamphetamine and codeine), all the doctors expressed a fear of what was going to happen, particularly in relation to their career. Most are terrified about the repercussions of their situation and ask the same questions:
- “Is this confidential?”
- “If I come in to see you will you report me to AHPRA?”
- “Will I ever be able to work again?”
When a doctor is committed to a recovery program and doing what is required, we would notcontact AHPRA. Furthermore, we regard work as an important part of a doctor’s recovery and motivation to stay well. If a participant’s recovery is stabilised, then there is no reason why he or she can’t work. In the event of a lapse or relapse, we ask that the doctor contacts us immediately to discuss what has happened.
While the recovery time of those who attend Caduceus varies, the common bond shared is a desire to live a life that is full, enriching, rewarding and not controlled by drugs. Furthermore, substance dependence is not a condition that goes away on its own – commitment to a recovery program and on-going support is essential.
If you are a doctor abusing substances, you are not alone. There are other doctors throughout Victoria who have experienced addiction problems and overcome them and now leading happy and productive lives — professionally and otherwise. I have been fortunate enough to have attended Caduceus on a number of occasions over the years and I never cease to be touched by the courage, care and camaraderie of this special group.
Psychologist & Case Manager
Victorian Doctors Health Program
If you are a doctor experiencing issues with substance use, or if you think you know a medical practitioner who may have a drug problem, we urge you to contact the VDHP either by email firstname.lastname@example.org or by phoning (03) 9280 8712. Anonymous enquiries are welcome.
This article appears in the December 2018 edition of Vicdoc.