Journal of addictive diseases
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Randomized Controlled Trial Comparative Study Clinical Trial
Physician substance abuse impairment: anesthesiologists vs. other specialties.
This is a retrospective case control study comparing relapse and recovery rates between addicted anesthesiologists and other physicians. Thirty-two anesthesiologists were compared with thirty-six randomized physician controls; all were followed for an average of 7.5 years over a 12-year period by the Medical Society of New Jersey's Physician Health Program. The relapse rate among anesthesiologists was 13 (40%) and for controls were 16 (44%). ⋯ These groups were stratified for residents vs. attendings and for those who changed their primary specialty during treatment and again, no statistical significance was noted between the two groups. The only significant difference in the groups noted was a higher opiate abuse rate for anesthesiologists (78%) vs. other physicians (42%) (p = 0.002). These findings suggest that with aggressive follow up and monitoring, clinicians can expect similar relapse and recovery rates for anesthesiologists as others.
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(1) Examine physician and nursing staff compliance with conducting an alcohol screening interview; (2) Compare compliance with the interview with usual physician and nurse assessment of drinking; (3) Examine reasons why drinking information might not be collected. ⋯ (1) Compliance with administering a standardized alcohol screening interview was low. (2) Nurses, and residents in family practice and internal medicine made some assessment of drinking for most patients. Surgeons assessed drinking in a minority of patients. (3) Expressed reasons for not administering the standardized interview included discomfort with the interview, viewing the interview as too time-consuming, or not part of the usual responsibilities of the nurses or residents. Other possible reasons for the low levels of compliance are discussed.
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Trauma is one of the leading causes of morbidity and mortality in the U. S. and alcohol makes a significant contribution to this problem. Alcohol has been demonstrated to increase the incidence of trauma through its ability to alter behavior and impair motor performance. ⋯ However, length of stay was significantly shorter for intoxicated patients. This study supports the concept that acutely intoxicated trauma victims suffer as many consequences as non-intoxicated patients, with the exception of length of stay. A discussion of these findings along with other reports on injury severity and alcohol use is included at the end of the paper.
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Editorial Comment
The medical use of marijuana: the case for clinical trials.