Relapse and recovery: five to ten year follow-up study of chemically dependent physicians--the Georgia experience.

Of 100 physicians who entered into a continuing care contract during a five-year period with the Impaired Physicians Program of the Medical Association of Georgia, seventy-seven have maintained documentable abstinence from all mood-altering substances. One physician was lost to follow-up. Twenty-two relapsed, eighteen of whom have undergone another treatment for chemical dependence. Only one physician in the relapse group has been involved in a pattern of chronic relapsing behavior.

Alcoholism and other drug addictions: a primary disease entity, 1991 update.

Intensive work needs to continue on the genetic characteristics of the X-Y chromosome. There needs to be further clarification of the allele penetrants and the oncogenes, as well as determination of the specific chromosomes. It is now apparent that the neurotransmitters, particularly dopamine, seratonin, and norepinephrine, as related to the MFB receptor sites, are a determining factor in the presence or absence of this disease. However, the exact manner in which these neurotransmitters and receptor sites act, particularly in terms of the feed-back systems, remains obscure. New receptor sites are also being discovered and additional neurotransmitter systems, such as the second messenger system, uncovered. It would be naive at this point to attempt to delineate specific receptor sites or neurotransmitter systems as the absolute determinant of the disease. However, the basic heuristic model accepted by the Georgia Impaired Health Professionals Program remains valid. The heuristic model proposed in the past 15 years remains basically intact and valid. In this model, it is apparent that the essential disease criteria are fulfilled by alcohol and other drug addictions. Chemical dependency is a primary, psychosocial, biogenetic disease. The American culture, however, often fails to appreciate the difference between controlled abusive use and the uncontrolled addictive user. They do not understand that controlled abusive use can lead to severe physical changes, even death.(ABSTRACT TRUNCATED AT 250 WORDS)

The effect of physician impairment on the family.

There are few studies on the effect of physician impairment on the marriage and the family. There is a need for research on both the functional and non-functional medical marriage, and treatment needs to be devised to focus on the special needs of the medical family.

Addiction in anesthesiologists: drug access and patterns of substance abuse.

Impaired anesthesiologists (IAs) seen by the Medical Association of Georgia Impaired Physicians Program were compared to all other impaired physicians seen by the program. Anesthesiologists were the specialists most overrepresented in the program. When each IA was matched to a control with respect to age, sex, race, professional activity status, and year of admission to the program, the IAs were found to be more likely to abuse drugs than alcohol, to abuse narcotics, and to abuse drugs intravenously. The authors recommend tighter control of narcotics and surveillance of all anesthesia personnel in order to reduce the risks to patients associated with chemical dependence.

The Medical Association of Georgia's Impaired Physicians Program. Review of the first 1000 physicians: analysis of specialty.

Risk factors for the disease of chemical dependence, or addiction to alcohol and/or drugs, for physicians have not been clearly defined. Yet chemical dependence is believed to be a leading occupational hazard for physicians. This study compares the specialties of a population of physicians assessed for the presence of impairment (study group, N = 1000) with the distribution of specialties for all US physicians. Only 21 of the total were found to be free of impairment from chemical dependence or psychiatric disease, while 920 physicians (92.0%) had a primary diagnosis of chemical dependence, and 59 (5.9%) had a major psychiatric illness. Anesthesia and family and general practice were found to be overrepresented in the population under study, as compared with all US physicians. There were significant differences between the study group and all US physicians with respect to age, sex, and practice activity status. The authors urge these apparent high-risk specialties, as well as the medical profession itself, to develop control or prevention strategies that will reduce risk for chemical dependence through education, early identification, intervention, and treatment of those individuals with the disease.