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BMJ 2005; 330 doi: (Published 31 March 2005) Cite this as: BMJ 2005;330:749
  1. Alison Tonks, associate editor (

    Family history and mental illness increase likelihood of relapse among health professionals recovering from addiction

    Between 1991 and 2001, 300 health professionals recovering from drug or alcohol addiction enrolled in the Washington Physicians Health Programme for post-treatment monitoring.A quarter of them eventually relapsed (74/292). Analysis of 11 years of patient data fromthe programme showed that risk of relapse was increased among professionals with coexisting mental illness (hazard ratio 2.25, 95% CI 1.23 to 4.11) or a family history of addiction (2.25, 1.44 to 3.64). Those who used a major opioid such as fentanyl were also more likely to relapse, but only if they also had a coexisting mental illness (5.79, 2.89 to 11.42) (figure). One relapse increased the risk of another (1.69, 1.13 to 2.53).

    Credit: JAMA

    All health professionals who stayed in the programme for more than five years without relapsing returned to work. So did 61% (31/51) of those who relapsed. The study's authors are careful not to generalise about who should be allowed back to work, but they do suggest that …

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