Pubdate: Sun, 08 Feb 2004 Source: Johnson City Press (TN) Copyright: 2004 Johnson City Press and Associated Press Contact: http://www.johnsoncitypress.com/ Details: http://www.mapinc.org/media/1983 Author: Sue Guinn Legg PROGRAMS GIVE AID TO DOCTORS, BOASTS OF HIGH RECOVERY RATE While research shows one in 10 people will misuse drugs at some point in their lifetime, when the abuser is a doctor, nurse or pharmacist responsible for the well-being of others, the problem becomes a matter of public health. "It's certainly a concern," said Judy Eads, assistant commissioner of the Tennessee Department of Health's Bureau of Licensing and Regulation. "It may be only a small portion of overall licensees in a profession, but the concern is for citizens at risk by exposure to an unsafe practitioner." To put things in perspective, Eads noted that fewer than 1 percent of the state's health care professionals are ever brought before the licensing boards for any type of complaint. Of those who do, more than half - 65 percent of nurses and 56 percent of doctors last year - are there because of alleged drug-related violations. To address the risks, the state's 28 health-related boards apply sanctions ranging from license revocations to temporary suspensions with practice restrictions that can be lifted as licensees work through probationary periods of treatment and counseling. To keep the public informed, the health department regularly announces disciplinary actions taken by the boards and also posts the information on the license verification section of its Web site at www.state.tn.us/health. Along with that, Eads said, the state also recognizes "the need to keep good workers in the system," and to that end contracts with independent peer assistance programs across Tennessee to help health care professionals maintain their licenses and return to practice. Dr. Jack Woodside, assistant medical director for the Tennessee Medical Foundation's Physicians Health Plan for doctors with addictions and other problems that may impair their practices, said while watchdog groups often call for stiffer sanctions and more public notification of drug violations, the TMF believes the therapeutic approach taken by programs like the PHP is more effective. As with any disease, Woodside said, the goal is to identify and treat addiction as early as possible. The voluntary and confidential nature of recovery programs like the PHP is intended to encourage practitioners to seek help, he said, rather than driving them underground in fear of sanctions and public disclosure. "If there is a risk of sanctions, they are more reluctant to come in for help and more likely to stay impaired," he said. "Addictions may go on longer and to greater levels." It is important for physicians to know that the PHP is not obligated to notify the state, employers or insurance carriers of a doctor's request for help and that the program instead serves as an advocate for the physician in mediations with those organizations, he said. Woodside attributes higher rates of success found among physicians in recovery than in the general population - 85 percent to 90 percent for doctors compared to 40 percent to 50 percent overall - to a combination of the support provided by programs like the PHP and strong professional contingencies. "Most doctors are highly motivated to keep their careers," he said. "And there are very few professions with this type of program to identify addictions early and to assist with treatment and follow up." "Doctors have the advantage of programs like this with mandates for treatment. In the Tri-Cities today, most end up in intensive counseling for a few hours a day most days of the week and most (undergo treatment) at facilities where the lengths of stay are three months or longer." Part of a network of independent recovery programs working with health care professionals across the state, the PHP is joined locally by the Tennessee Professional Assistance Program for nurses and the Tennessee Pharmacists Recovery Network for druggists. Together, the three programs facilitate more than an half dozen support groups in the Tri-Cities area. Typically, the programs begin with an evaluation of an individual's level of dependency and need of treatment and the formulation of a recovery plan that may range in duration from three to eight years. Often, the plans include an intense period of intense treatment followed by years of weekly group therapy sessions with other health care providers recovering from addictions. Most often, Bill Hamil an evaluator for the TPAP program said, nurses who come to the program are those who have tested positive on a drug screen and want to keep their jobs. Their problems are accumulative, he said, a combination of high-pressure jobs in which staff shortages "have everyone working in higher gear" and ordinary "people problems" like divorce, finances and illness. And while there is "no cookbook approach" to recovery, Hamil said, the advantages of joining a group like TPAP are the group's "solid connection to the treatment community" and the counsel of others in like situations. "Its always helpful to meet people who have succeeded in what you are trying to do," he said. Jerry Naylor, a group facilitator for TPAP, said while "everyone's story is a little different," some of the key common denominators are accepting addiction as an illness, recognizing a lifestyle that has to be broken and addressing the ongoing challenges of routine access to drugs in the workplace. Relapses happen and some nurses change the path of their careers to avoid the risks of dispensing drugs to others, he said. "The important thing is, if you're on that downward escalator of addiction, you don't have to go all the way to the bottom. You can step off any time." - --- MAP posted-by: Josh