PSYCHOACTIVE SUBSTANCE USE AMONG AMERICAN ANESTHESIOLOGISTS - A 30-YEAR RETROSPECTIVE STUDY

The purpose of this study was to assess the cumulative incidence of su bstance use among anesthesiologists during training and practice, the effect of stress on drug use, and deterrent efficacy of institutional prevention programmes. The 260 anesthesiologists who had trained at th e Medical College of Wisconsin between 1958-1988 were surveyed by mail regarding psychoactive substance use. Analysis of 183 responses focus ed on demographic and psychosocial factors. Substances used most frequ ently included: alcohol (91.6%) marijuana (30.8%) and cocaine (9.4%). Twenty-nine (15.8%) anesthesiologists were identified as being substan ce-dependent: 19 were alcohol-impaired; six were drug-impaired, and fo ur were dependent on both alcohol and drugs. Impairment was more preva lent in anesthesiologists who had completed their training after 1975 Fifty-eight (32%) anesthesiologists had used illicit drugs to ''get hi gh''; 11 acknowledged daily use for two weeks or more, with eight admi tting dependency. Substance abuse was more common in parents of impair ed anesthesiologists (35.7%) than in unimpaired colleagues (8.1%; P < 0.001). The divorce rate for impaired anesthesiologists (24.1%) was gr eater than for unimpaired anesthesiologists (5.2%; P < 0.001). Increas ed stress during training was not rejected by increased substance use. Few recalled any drug counseling whatsoever Seventy percent assessed hospital drug control policies as fair or poor Younger respondents (bo rn after 1951) were more critical of drug control programmes than thei r older cohort. Incidents of substance abuse were reported for both re sidents and faculty. Psychoactive substance abuse remains a serious pr oblem among anesthesiologists.