Intended for healthcare professionals


Missed problems and missed opportunities for addicted doctors

BMJ 1998; 316 doi: (Published 07 February 1998) Cite this as: BMJ 1998;316:405

We need a special service for doctors addicted to drugs or alcohol

  1. John Strang, Professor of the addictionsa,
  2. Michael Wilks, Chairmanb,
  3. Brian Wells, Medical directorc,
  4. Jane Marshall, Consultant psychiatrist in the addictionsd
  1. a National Addiction Centre, Institute of Psychiatry, London, SE5 8AF
  2. b Medical Ethics Committee, British Medical Association, London WC1H 9JP
  3. c Riverside Mental Health Trust, London W6 8DW.
  4. d National Addiction Centre, Institute of Psychiatry, London, SE5 8AF

    Every few days another addicted doctor comes to light in Britain. A report from an alliance of health professional bodies, led by the British Medical Association and published last month,1 highlights the risk posed by such doctors to the general public and calls for better preventive education and awareness. It fails, however, to prioritise the need for improved treatment for addicted doctors.2 This need arises from the special problems facing addicted doctors compared with other addicts and their special treatment needs, which ordinary addiction services do not serve well.

    Doctors are at special risk of developing addiction problems,3 4 5 owing to the strain of medical practice, erosion of the taboo against injecting and opiates, and, particularly, access to supplies.6 Once addicted, they pose a particular risk to the general public, forcing consideration of whether they need urgent removal from their work. Ordinarily, many patients with drug or alcohol problems receive outpatient treatment while continuing to work, but the same level of disability may be incompatible with medical practice. In addition, since most doctors who become addicted to drugs …

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