In the wake of the COVID-19 pandemic, healthcare workers, including doctors, are struggling with burnout and stress—but many also struggle with substance use issues.

Support is available, but many physicians avoid seeking help. Why are they so reluctant, and how can they overcome these challenges?

 

High levels of substance abuse

Key findings from the report, which used data from 1,000 healthcare workers in the United States, indicated that:

• 14% of physicians consume controlled substances or alcohol while at work

• 21% consume controlled substances or alcohol several times each day

• 17% consume controlled substances or alcohol at least once each day

While the exact reasons a person may struggle with addiction issues vary greatly, depending on personal life circumstances, the report also pointed to situations affecting healthcare providers, in particular, that may be causing them to turn to substances to cope.

The researchers found that 40% of doctors were anxious or felt dread about going to work, and 49% said they were at their breaking point or were looking for alternative employment due to the trauma and stress of their current jobs.

Additionally, political issues affecting the healthcare industry may be to blame, in some cases at least. Of the physicians surveyed, 64% said the overturning of Roe v. Wade, which eliminated women’s rights to abortion, has increased stress levels.

A Mayo Clinic study published in 2021 found that the COVID-19 pandemic “placed unprecedented stresses on health care workers with work overload, job insecurity, worries about personal and family safety, and exposure to patients dying at unaccustomed rates.”

Sinsky CA, Brown RL, Stillman MJ, et al. COVID-related stress and work intentions in a sample of US health care workers. Mayo Clin Proc Innov Qual Outcomes. 2021;5(6):1165–1173.

 

A study of a single institution in New York City published in Chronic Stress found that 39% of frontline workers had symptoms of major depressive disorder, PTSD, and/or generalized anxiety disorder.

Feingold JH, Peccoralo L, Chan CC, et al. Psychological impact of the COVID-19 pandemic on frontline health care workers during the pandemic surge in New York City. Chronic Stress (Thousand Oaks). 2021;5:2470547020977891.

 

The APN study found that men seem to struggle more than women, although both groups face problems:

• Men were 5 times more likely to use their position to obtain controlled substances.

• Men were 4.5 times more likely to use controlled substances or alcohol at work.

• Men were 2.5 times more likely to use controlled substances or alcohol in the 12 hours leading up to the start of their shift.

 

Denial and stigma

It’s not only burnout and job stress that contributes to substance misuse among physicians. A review published in Drug and Alcohol Dependence found several other factors contributing to problems with addiction, noting that denial may be one of the main reasons doctors continue to use substances.

Vayr F, Herin F, Jullian B, et al. Barriers to seeking help for physicians with substance use disorder: a review. Drug Alcohol Depend. 2019;199:116–121.

 

Additionally, common personality traits among successful practitioners, including independence, perseverance, and self-confidence, could be partially responsible for their unwillingness to seek out help.

These findings were echoed by the APN report, which found that about 30% of male providers didn’t want to admit they have a problem, while 28% were concerned about how colleagues, family, and friends would judge them if they sought mental health treatment.

The stigma of substance abuse, and the potential professional repercussions from admitting to it, can be strong deterrents to seeking help among doctors. The APN report indicated that approximately 28% of male physicians and 8% of female physicians refrain from seeking help for fear of having their professional licenses revoked.

 

Support for addiction issues

Unfortunately, about 25% of physicians with substance use problems don’t know where to turn for help. However, there are several treatment options designed to help medical professionals overcome their addiction problems.

Treatment options vary depending on the severity of the addiction. For more minor issues, treatment may be done on an outpatient basis, including behavioral counseling and long-term follow-up.

Buffo J. Drug & alcohol rehab for healthcare professionals near you. American Addiction Centers. September 13, 2022.

These approaches may help doctors adopt healthy coping skills and change their attitude toward substance use.

 

For more severe addiction problems, detoxification and inpatient residential treatment may be necessary. These treatments, managed by medical professionals, enable physicians to safely discontinue their substance abuse and begin the process of recovery. The intensive rehabilitation and counseling they receive may be key for some doctors who need this level of assistance.