Addiction Prediction Testing

[TheSeanieB]

Just curious if there is anything out there on addiction rates among anesthesiologists and risk factors for addiction (ie personality types, past drug abuse)?

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[lobelsteve]

Just curious if there is anything out there on addiction rates among anesthesiologists and risk factors for addiction (ie personality types, past drug abuse)?

ORT. http://www.partnersagainstpain.com/printouts/Opioid_Risk_Tool.pdf

SOAPP-R. http://www.painedu.org/soapp.asp


Good risk tools for screening patients.

 

[urge]

Just curious if there is anything out there on addiction rates among anesthesiologists and risk factors for addiction (ie personality types, past drug abuse)?

Those who need to ask are at high risk.

 

[TheSeanieB]

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[WholeLottaGame7]

Those who need to ask are at high risk.

I would disagree. I think it's a legitimate concern and worth paying attention to. I think those who think it doesn't pertain to them and pretend it doesn't exist are at higher risk.

 

[QofQuimica]

I would disagree. I think it's a legitimate concern and worth paying attention to. I think those who think it doesn't pertain to them and pretend it doesn't exist are at higher risk.

Agree.

OP, it's great that you are educating yourself and other students about this problem. There are many good articles about the higher prevalence of opioid addiction in particular among anesthesiologists compared to other specialties. (FWIW, CRNAs have an increased rate of addiction compared to other nurses as well.) You might find this review article to be a good starting point.

Known risk factors for addiction among anesthesiologists include younger age; male gender; Americans (vs immigrants from other countries); high-achievers (think type A kind of personality); limited support system; PMH psychiatric comorbidities; and previous history of substance abuse.

Hope this helps, and best of luck with your presentation.

 

[ghost dog]

Just curious if there is anything out there on addiction rates among anesthesiologists and risk factors for addiction (ie personality types, past drug abuse)?

By far the best predictor for substance abuse: past personal history of any sort of substance abuse.

 

[TheSeanieB]

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[Gern Blansten]

Do residency programs ask about past drug abuse in the selection process? Are there any personality tests that correlate with the probability that a future anesthesiologist is more prone to abuse the medications they have access to?

I have never heard of a program that routinely asks that question. I'm not sure how honest people would be if asked if it had not previously led to a criminal record. So, I am not sure it would be a very high yield question.
Certainly, a couple of DUI's on your application would raise concerns (now asked about and appear on ERAS application and I think there is a requirement to be completely honest on that form at the risk of losing your residency spot if it is found out that you lied about something of that nature).

 

[pgg]

Just curious if there is anything out there on addiction rates among anesthesiologists and risk factors for addiction (ie personality types, past drug abuse)?

Sorry I was actually refering to the risk that an anesthesiologist will self medicate. I'm doing research for our club at school and was hoping to find some good information to present.

Do residency programs ask about past drug abuse in the selection process? Are there any personality tests that correlate with the probability that a future anesthesiologist is more prone to abuse the medications they have access to?

I know you said you're researching this for the pre-anesthesia club at school, and I don't mean to doubt you, but it almost sounds like you're asking because this is a specific concern to you. Asking these questions because you're worried about your own history and how it might affect your risk as an anesthesiologist shows good judgment and insight. If you're really not asking about you, my apologies, don't be offended.



I've known two CRNAs and two other healthcare workers who've become addicted to opiates obtained via diversion, and although they are all presently still alive, they essentially lost almost everything important in their lives. Two did jail time and their healthcare careers are over. I'm pretty sure the latest will relapse at some point, I just have that feeling. He wants to return to anesthesia practice ASAP. He's going to be dead within a year if that happens, so for his sake, I hope the state nursing board prevents it.

It's all about access. It's so easy to take the stuff. It's impossible for colleagues or the institution to prevent it. It's impossible to detect the diversion until the quantities get so large, or the addiction so alters their judgment that they get sloppy.

My opinion is that if you have a history of illicit drug abuse, do NOT choose anesthesia. Pick another specialty where you won't have a dozen vials of fentanyl passing through your hands EVERY DAY with nobody watching you. There are lots of rewarding and fulfilling specialties that don't involve carrying around syringes with blue stickers on them.

Anesthesia is a stressful field, residency sucks hard sometimes, people will be mean to you, the hours are long ... If you're a recovering addict, your brain is physically different, your risk/benefit calculus is forever changed.

I think most anesthesiologists or CRNAs who divert should not return to practicing anesthesia - not as punishment, or even public protection - but because the relapse risk is high, and their health and lives are at really, really high risk.

I know a lot of people will disagree with me, will say that return to supervised practice is safe, and a good thing because it encourages addicts to seek help prior to dying or being caught. There's merit to that point of view.


I'm not talking about people who smoke or smoke a little pot here or there, or who were binge drinkers with their frat buddies in college. Hard illicit drug use in the past should be a huge red flag and give pause to anyone considering anesthesia as a career, IMHO.

 

[QofQuimica]

Do residency programs ask about past drug abuse in the selection process?

None that I'm aware of, but my state medical board sure did, even though I was only applying for my limited license.

Are there any personality tests that correlate with the probability that a future anesthesiologist is more prone to abuse the medications they have access to?

Ah, if only there was a way we could do this, we'd save a lot of lives (and livelihoods too).

My opinion is that if you have a history of illicit drug abuse, do NOT choose anesthesia. Pick another specialty where you won't have a dozen vials of fentanyl passing through your hands EVERY DAY with nobody watching you. There are lots of rewarding and fulfilling specialties that don't involve carrying around syringes with blue stickers on them.

Anesthesia is a stressful field, residency sucks hard sometimes, people will be mean to you, the hours are long ... If you're a recovering addict, your brain is physically different, your risk/benefit calculus is forever changed.

I think most anesthesiologists or CRNAs who divert should not return to practicing anesthesia - not as punishment, or even public protection - but because the relapse risk is high, and their health and lives are at really, really high risk.

I know a lot of people will disagree with me, will say that return to supervised practice is safe, and a good thing because it encourages addicts to seek help prior to dying or being caught. There's merit to that point of view.

I'm not talking about people who smoke or smoke a little pot here or there, or who were binge drinkers with their frat buddies in college. Hard illicit drug use in the past should be a huge red flag and give pause to anyone considering anesthesia as a career, IMHO.

I agree with you completely.

 

[kazuma]

I remember at least one program that asked about previous abuse during interviews. It's a real problem. I interviewed at cincinnati a couple days after a resident had died due to abuse (inhalation agent iirc)

 

[Gern Blansten]

I think most anesthesiologists or CRNAs who divert should not return to practicing anesthesia - not as punishment, or even public protection - but because the relapse risk is high, and their health and lives are at really, really high risk.

I agree with you . I think that once you stick that needle in your own vein, you are effectively saying that you no longer want to be an anesthesiologist. Relapse is very high. Some say it is not a matter of "if," it is a matter of "when" the relapse will occur. I believe that two independent papers found that the first sign of relapse was being found dead in ~25% of the cases. Most training programs have been affected. If they haven't, they weren't looking close enough.