Mary Rohman

Psychoactive Drug Use among Practicing Physicians and Medical Students

We surveyed random samples of 500 practicing physicians and 504 medical students in a New England state during 1984-1985; 70 percent of the physicians and 79 percent of the students responded. Fifty-nine percent of the physicians and 78 percent of the students reported that they had used psychoactive drugs at some time in their lives. In both groups, recreational use most often involved marijuana and cocaine, and self-treatment most often involved tranquilizers and opiates. In the previous year, 25 percent of the physicians had treated themselves with a psychoactive drug, and 10 percent had used one recreationally. Although most of the use was experimental or infrequent, 10 percent of the physicians reported current regular drug use (once a month or more often) and 3 percent had histories of drug dependence. More physicians and medical students had used psychoactive drugs at some time than had comparable samples of pharmacists and pharmacy students. The results suggest a need for renewed professional education about the risks of drug misuse.

Alcohol use and abuse in random samples of physicians and medical students.

BACKGROUND This study sought to resolve conflicting views about whether physicians are especially prone to alcohol abuse. METHODS Using an anonymous, mailed questionnaire on substance use, we surveyed 500 physicians, 510 pharmacists, and 974 of their students. The physicians and pharmacists were selected randomly from the state societys membership lists, and students selected were from local school lists. Follow-up surveys were sent to nonresponders at two-week intervals. RESULTS The physicians and medical students did not drink especially heavily and were no more vulnerable to alcoholism than were their counterparts in pharmacy and other professions. Physicians differed from pharmacists in their style of drinking (greater frequency, smaller quantity), but not in total amount of alcohol consumed. Drinking habits among physicians were not associated with medical specialty or type of practice, but were positively related to gender (males drank more than females) and to age (older doctors were more apt to qualify as heavy drinkers than were younger doctors). CONCLUSIONS Physicians were no more likely to abuse substances nonmedically than were other professionals. Any group in which alcohol use is nearly universal incurs a risk of abuse and impairment that cannot be ignored.

Psychoactive drug use by young and future physicians

Drug-use surveys of nonclinical samples of young physicians and premedical, medical, and nursing students in New England indicate that between 56 and 70 percent have used marijuana and that some of them now have progressed to recreational experimentation with higher-risk drugs, especially cocaine (15 to 21 percent). At the same time, use of amphetamines for studying and staying awake appears to have declined in prevalence. These figures reflect the influence of current drug-use trends among university populations, although future health professionals consistently have slightly lower drug-use rates than many other graduate and college students. Approximately 40 percent of the young physicians also treated themselves with one or more psychoactive drugs, mostly opiates (27 percent), tranquilizers (17 percent), and sedatives (8 percent). Although most subjects have used drugs only afew times, some reported more regular use; the latter therefore may be at risk of developing drug problems.

Risk Factors of Drug Impairment in Random Samples of Physicians and Medical Students

The prevalence of hypothesized risk factors of drug impairment is estimated and correlated with drug use in random samples of physicians and medical students. Substantial percentages of both physicians and medical students reported access to drugs, family histories of substance abuse, stress at work and home, emotional problems, and sensation seeking. Each of these factors correlated with drug use in physicians or medical students, and analysis suggested that in most cases the hypothesized risk factors were more likely to be causes rather than consequences of drug use.

The Role of Euphoric Effects in the Opiate Addictions of Heroin Addicts, Medical Patients and Impaired Health Professionals

Although the importance of euphoria-seeking in opiate addiction has been debated by leading drug abuse theorists including Lindesmith, Wikler, Brill, Bejerot and others, few researchers have heretofore collected systematic data on the issue. Statistical and case study data obtained over the past few years show that euphoria-seeking is a major cause of opiate addiction for most nontherapeutic addicts but for only a few therapeutic addicts. Theoretical analysis and empirical data indicate that euphoria-seeking is also a key component in the causation of many of the secondary problems of nontherapeutic addiction, including crime, unemployment, death, and disease. In the absence of euphoria-seeking, opiate addiction would be a much less severe public health and social problem.

EMOTIONAL PROBLEMS AND CONCERNS OF NEW ENGLAND COLLEGE STUDENTS

Data collected in a questionnaire survey of more than 7000 undergraduates at 34 New England colleges and universities indicates that prevalence of common problems experienced by students was significantly associated with sex, health status, academic standing, drug use, and difficulties with weight control.