Monday, November 28, 2011

Five year outcomes for physicians treated for substance abuse

Here is the abstract of a great article showing what great success we can have treating substance abuse.

Five year outcomes in a cohort study of physicians treated
for substance use disorders in the United States


A Thomas McLellan, chief executive officer,1 Gregory S Skipper, medical director,2 Michael Campbell,
research scientist,3 Robert L DuPont, president3

ABSTRACT
Objective To evaluate the effectiveness of US state
physician health programmes in treating physicians with
substance use disorders.

Design Five year, longitudinal, cohort study.
Setting Purposive sample of 16 state physician health
programmes in the United States.

Participants 904 physicians consecutively admitted to
one of the 16 programmes from September 1995 to
September 2001.

Main outcome measures Completion of the programme,
continued alcohol and drug misuse (regular urine tests),
and occupational status at five years.
Results 155 of 802 physicians (19.3%) with known
outcomes failed the programme, usually early during
treatment. Of the 647 (80.7%) who completed treatment
and resumed practice under supervision and monitoring,
alcohol or drug misuse was detected by urine testing in
126 (19%) over five years; 33 (26%) of these had a repeat
positive test result. At five year follow-up, 631 (78.7%)
physicians were licensed and working, 87 (10.8%) had
their licences revoked, 28 (3.5%) had retired, 30 (3.7%)
had died, and 26 (3.2%) had unknown status.
Conclusion About three quarters of US physicians with
substance use disorders managed in this subset of
physician health programmes had favourable outcomes
at five years. Such programmes seem to provide an
appropriate combination of treatment, support, and
sanctions to manage addiction among physicians
effectively.

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