Various studies and surveys have shown the incidence of addiction to alcohol and drugs is higher than that of the general population – and probably rising.
The increasing pressures on doctors mean it can be all too easy to self-medicate with drugs or alcohol. The occasional glass of wine to relax can easily become an every-night activity with the glass to wind down quickly becoming a bottle. Addiction and unhealthy coping strategies can be difficult to recognise and often seen as a sign of weakness. Drugs and alcohol aren’t the only issues facing doctors – eating disorders and gambling are also common problems.
The Sick Doctors Trust comments that ‘Alcohol is the commonest substance of abuse in all doctors. Drinking will surprisingly continue despite negative consequences such as job difficulties, relationship breakdowns, financial problems, loss of driving licence; the alcoholic is driven by an irrational compulsion to continue, and frequently results in despair to the point of suicide. Fortunately, the depression associated with active alcoholism often abates when sober’.
GMC figures of all cases of health sanctions in doctors show GPs are the most likely specialists to be affected (39% compared to 17.5%, Psychiatrists, 9% General Medicine, 8.5% Surgery, 6.5% Anaesthesia & 6.2% Emergency Medicine. Other specialities represented less than 2% each (reference Dobson B. Head of Case Review GMC 2010, personal communication).’
The BMA comments that ‘research at the Doctors for Doctors Unit of the BMA shows that only one in three doctors would see their GP when unwell, despite almost all being registered with one (which is often simply required for work, insurance and so on). One in eight doctors reported that they use alcohol or drugs to help them cope with work and ill health, about one in four reported knowing of colleagues who do so.’
AUDIT: The AUDIT is a more detailed questionnaire. It has been developed by the World Health Organization as a simple screening tool to pick up the early signs of hazardous and harmful drinking and identify mild dependence.
SADQ: The SADQ is a short, self-administered, 20-item questionnaire was developed by the Addiction Research Unit at the Maudesley Hospital to measure severity of dependence on alcohol.
Where to get help - Doctor specific support
Disclaimer – doctors in difficulty with their physical and mental health should always consult their GP for help and avoid ‘corridor consultations’ and self-treatment.
NHS Practitioner Health is a confidential NHS service for healthcare practitioners and GP trainees in England. The NHS Practitioner Health Service can help with issues relating to a mental health concern, including stress or depression, or an addiction problem, in particular where these might affect work. Access the service by emailing firstname.lastname@example.org or by calling 0300 0303 300. The service is available 8am – 8pm Monday – Friday and 8am – 2pm Saturday. Please note the service is not for emergency or crisis issues. These should be directed to mainstream NHS.
The Sick Doctors Trust: this is an independent charity offering free confidential help and support for doctors suffering from addiction to drugs and alcohol via their 24 hour helpline. The trust can arrange contact with rehabilitation support services and support for relatives. The website has personal stories from doctors who have suffered with addiction. They are happy to take anonymous calls and also to talk to colleagues or family members of anyone experiencing dependency issue. There is no limit to how many times you can contact the service.
The BMA runs three services:
– BMA Counselling: Offers 24 hour telephone help and structured counselling sessions. You can remain anonymous and you do not have to be a BMA member to access support. Covers alcohol, substance abuse, debt
as well as issues such as depression, stress, bullying and GMC issues. Call: 0300 123 1245.
– The Doctor Advisor Service runs alongside BMA Counselling giving doctors and medical students in distress or difficulty the choice of speaking in confidence to another doctor. If you wish to use the service call 0330
123 1245 and ask to speak to a Doctor Advisor – you will be given the name of a doctor to contact and details of their availability. This is not an emergency service and if you find yourself in such a situation, please get
appropriate help from either your own GP or usual medical advisor. Doctor Advisors do not provide diagnoses or treatment, although inevitably any interaction will have a therapeutic aspect.
– Doctors Support Service: Doctors who face GMC investigations or license withdrawal have access to a new, confidential support service from the BMA. They recognise that being subject to a complaint or learning
your license is at risk can be uniquely and deeply stressful. They also understand that many doctors might not have anyone to confide in while they undergo a GMC investigation. As a result the GMC commissioned
them to provide the Doctor support service, which offers emotional help from fellow doctors and functions independently of the GMC.’ Call 020 7383 6707 (Monday to Friday, 9am to 5pm). Email:
International Doctors in AA (IDAA) is a worldwide fellowship of more than 9,900 healthcare professionals, and their families, who strive to help one another to achieve and maintain recovery from addictions.
Medical Council on Alcohol: A body of doctors and others with a professional interest in alcohol and alcoholism which aims to promote understanding of alcoholism, its treatment and prevention. The MCA offers a support service and a network of regional advisors linked to medical schools. If you would like to discuss a matter concerning yours or a colleague’s health then please contact the Medical Director, Dr Dominique Florin, in confidence. Email: Dominique.Florin@m-c-a.org.uk. Telephone: 020 7487 4445.
British Doctors’ and Dentists’ Group: Network of support groups for doctors recovering from, or seeking to recover from, addiction to or dependency on alcohol or other drugs. Tel: 07792 819 966. Founded in London in 1973 by two doctors recovering from alcohol addiction, who recognised the benefits of meetings and mutual support of others with similar experiences, the BBDG now operates along the lines of AA however exclusively for doctors and dentists. They currently run 17 meetings throughout the United Kingdom and Ireland and are also allied with a group to provide support for the families of doctors and dentists who are addicted to drugs or alcohol. Telephone: 0779 2819 966. Email: email@example.com.
Doctors’ Support Network (DSN) is a fully confidential, friendly peer support group for doctors and medical students with mental health concerns including stress, burnout, anxiety, depression, bipolar disorder, psychoses and eating disorders. You can also get in touch by email.
Doctors Support Group: A free service with doctors attending from all across the UK whose primary aim is to enable those facing these bewildering and confusing situations to cope and eventually emerge with the minimum of professional and/or personal damage. Any doctor where a complaint has been made to the GMC, can ask for support from the Doctor Support Service, which offers emotional help from fellow doctors and functions independently of the GMC. Support is available from when a complaint is made until the outcome of the case. Doctors unable to talk with family or supportive colleagues may find the service particularly useful. Doctors facing suspension, exclusion, investigation of complaints and/or allegations of professional misconduct are under extreme stress. They find it difficult to know how to respond or to know which professional body or people to work with for support. Members of the DSG have been through these challenging times and offer recommendations based on their individual and collective experiences. Call: 0203 553 1570.
Additional help for addictions
Alcoholics Anonymous: A fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism. The only requirement for membership is a desire to stop drinking. Tel: 0800 9177 650 or contact by email: firstname.lastname@example.org or online chat via the website.
Drinkline: 24 hour free confidential alcohol helpline if you are concerned about yourself or someone else’s drinking. Helpline: 0300 123 1110 Opening Hours Weekdays 9am – 8pm, Weekends 11.00am – 4pm.
Soberistas: Online community supporting those attempting to remain abstinent from alcohol.
With You: A UK charity working solely in the field of drug and alcohol treatment, offering harm reduction services and structured day care programmes. Services throughout the UK. Tel: 020 7251 5860.
Addiction Helper: An addictions helpline offering free help for anyone affected by addiction including eating disorders with advice on both NHS & private drug & alcohol treatment options. Tel: 0800 44 88688 (freephone)
Rehab 4 Alcoholism: Rehab 4 Alcoholism provides independent advice for those seeking drug and alcohol rehabilitation. Offers treatment programmes throughout the United Kingdom and abroad.
Alcohol Concern: National charity offering support and information aiming to reduce drinking in the UK. Useful tools and resources on the website
Narcotics Anonymous: Non-profit community based meetings and support groups. Tel: 0300 999 1212.
Cocaine Anonymous: 0300 111 2285 (mobile friendly) or 0800 612 0225 10am – 10pm Every Day
Release: Offers counselling for those affected by drug and alcohol use and their families. For professionals and public – free and confidential specialist advice via telephone or email from lawyers and drug professionals about a range of issues including drug information, effects of drugs, harm reduction, matters involving drug dependency, types of treatment including maintenance prescribing and abstinence. Advice on legal matters such as travelling with prescribed controlled drugs, drug testing in the workplace, impact of (past) criminal convictions and cautions, charges involving possession of drugs, charges involving intention to supply drugs and cannabis cultivation offence. Telephone: 020 7324 2989. The telephone help & advice line is open from 11am—1pm & 2pm—4pm Monday to Friday. A message service is available 24 hours and we will return your call within one business day. Email: email@example.com.
Drug Addicts Anonymous: DAA is a fellowship of men and women who have recovered from drug addiction by following the Twelve Steps – a tried and tested programme of practical spiritual action. Our fellowship attracts drug addicts from many walks of life, who between them used many different drugs, both legal and illegal.
FRANK: National drugs helpline offering general advice and information. Referral onto local services. Open 24 hours. Tel: 0800 77 66 00 (freephone)
Drugsline: A freephone crisis and support line providing support, information and help including information on local services. Tel: 0808 1 606 606
Re-solv: A national charity solely dedicated to the prevention of solvent and volatile substance abuse (VSA). Offers support and information. Opening hours: Mon-Fri 9am-5pm. Tel: 01785 817 885.
Rehab Recovery: Rehab Recovery is an organisation that provides addiction treatment and healthcare advice for a wide range of different addiction and dependency problems.
Nacoa: The National Association for Children of Alcoholics is a charity whose aim is to support children whose parents suffer with problems with addiction or alcohol dependence.
Adfam provides support and information to families of alcohol and drug users. Tel: 020 7553 7640.
Families Anonymous: Support for family or friends affected by a loved ones drug problem or related behavioural problems. Opening hours: Mon-Fri 1pm-4pm. 6pm-10pm, weekends 2pm-10pm. Tel: 0845 1200 660
Al-Anon Family Groups offers understanding and support for families and friends of problem drinkers. Opening hours: 10am-10pm daily. Tel: 020 7403 0888 (confidential helpline)
Alateen: Support for young people age 12-20 who have been affected by someone else’s drinking. Opening hours: 10am-10pm daily. Tel: 020 7403 0888 (confidential helpline)
Rehab Online is a directory of residential rehabilitation services for adult drug and/or alcohol misusers in England and Wales. It will give you information about these services, whether you are a member of the public, a professional or a service user. Tel: 0844 414 6370.
Nottingham Recovery Network: Free support advice and treatment to anyone who uses drugs and alcohol in a problematic way across Nottingham City
CGL Nottingham – New Directions Nottinghamshire: a free and confidential drug and alcohol service for adults, based across Newark, Mansfield, Ashfield, Ollerton, Worksop, Hucknall, Broxtowe and Rushcliffe.
BMA guide about what to do if you are concerned about a colleague