Addiction and Substance Abuse in Anesthesiology

Despite substantial advances in our understanding of addiction and the technology and therapeutic approaches used to fight this disease, addiction still remains a major issue in the anesthesia workplace and outcomes have not appreciably changed. While alcoholism and other forms of impairment such as addiction to other substances and mental illness impact anesthesiologists at similar rates to other professions, as recently as 2005, the drug of choice for anesthesiologists entering treatment was still an opioid. There exists a considerable association between chemical dependence and other psychopathology and successful treatment for addiction is less likely when co-morbid psychopathology is not treated. Individuals under evaluation or treatment for substance abuse should have an evaluation with subsequent management of co-morbid psychiatric conditions. Participation in self-help groups is still considered a vital component in the therapy of the impaired physician, along with regular monitoring if the anesthesiologist wishes to attempt re-entry into clinical practice