• Lisa G Lefebvre and I Michael Kaufmann.
• Ontario Medical Association Physician Health Program, Suite 900, 150 Bloor Street West, Toronto, ON, M5S 3C1, Canada. Lisa.Lefebvre@oma.org.
• Can J Anaesth. 2017 Feb 1; 64 (2): 211-218.

PurposeThe purpose of this article is to review current evidence for the identification and management of substance use disorders in anesthesiologists and to describe an approach to return to practice.Principal FindingsAnesthesiologists experience substance use disorders at a rate reported to be 2.7 times that of other physicians. Effective evidence-based treatment is available for physicians with substance use disorders, including anesthesiologists. Significant barriers preventing access to such treatment still exist, some of which are specific to the physician cohort. Standard of care should involve ongoing monitoring of substance use disorders in a chronic disease management paradigm. The outcomes for anesthesiologists treated and monitored for a substance use disorder are similar to those for other physicians and significantly superior to those for the general population. Return to work is possible and is most effectively managed in an occupational health risk management model.ConclusionThe treatment of substance use disorders in anesthesiologists is effective, and a safe return to practice is possible in a majority of cases. National guidelines are needed to ensure equitable access to high-quality treatment and recovery monitoring for all Canadian physicians.

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