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Health Professionals

Health professionals are not immune to problems with drugs or alcohol. Apart from the general risk factors they share with the rest of the community, health professionals may be exposed to particular risks relating to:

• the demands, responsibilities and stresses of their professional lives
• conflict between their professional and personal lives
• easy access to prescription drugs
• self-treatment (often following self-diagnosis and self-investigation)
• reluctance of colleagues to confront or deal with early warning signs

Treating a Health Professional with Alcohol or Other Drugs Problems

• recognise that it has taken a great deal of courage (and perhaps some not-so-gentle persuasion) for a health professional to present to you for treatment
• treat them as a patient, not a colleague
• not assume anything about their knowledge of their problem
• not expect them to take more responsibility for their management than you would expect from any other patient
• assess them in the same way that you would assess any other patient – detailed history and appropriate physical examination are crucial and should never be circumvented
• treat them in the same way that you would treat any other patient – in these circumstances, they are your patient first and a health professional second
• provide them with the same information that you give to other patients
• assume nothing
• never allow them to prescribe or procure their own medications
• be directive about their follow-up
  • do not leave it up to them
  • ensure provision of adequate after-care with an ongoing care manager
• consider the impact of their problem upon their work
• believe that patient safety may be at risk
• advise the health professional accordingly
• seek advice from their registering authority such as the Medical Board or Nursing Board if they are not receptive to your advice

Dealing with a Colleague with an Alcohol or Other Drug Problem

• unexplained behaviour changes
• inappropriate prescribing
• administering patient medication in a secretive manner
• drug wastage, particularly in the case of illicit drugs
• poor compliance with documentation requirements; e.g. drug register
• patients complaining of inadequate pain relief
• collecting patient medications from the pharmacy
• unwillingness to respond to on-call responsibilities; e.g. refusing to return after-hours

Take action, or make sure that someone else does!

• not wanting to create waves
• hoping that someone else will take action
• unfounded fear of legal action
• not knowing what to do
• feeling intimidated by the person concerned

The Steps to Take

1. If you feel unable to deal with the matter yourself, make your supervisor aware of your concerns. Do not let the matter drop until you are sure that you have been taken seriously
2. If you feel able to talk to the colleague yourself, do not take on a treating role, but:
   • arrange to meet with them privately
   • let them know that you are concerned and why
   • ask for their version of events
   • ask them to consult with an appropriate specialist
   • provide them with contact information
3. Consider alerting their head of department or supervisor
4. Follow-up to make sure that they have taken your advice. Be aware that your colleague may tell you what they think you want to hear, having taken no positive steps

Registering Authorities

Being a Health Professional with an Alcohol or Other Drug Problem

• You may feel that with your professional knowledge and skill you should be able to control and manage your problem – experience shows that this is rarely the case.
• You may feel that asking for help is an admission of personal or professional inadequacy – unfortunately, the consequences of failing to seek help may be far more detrimental to your personal and professional life.
• If you have developed a functional relationship with your GP then they are the appropriate person to help you with your problems in the first instance and you are encouraged to seek their assistance sooner rather than later.
• Do not try to ‘go it alone’ – you will need professional support and advice.

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