In the national discussion about the opioid crisis, physicians are often lumped in with pharmaceutical companies as being responsible for getting people addicted to opioids. Some doctors who overprescribe patients and even set up pill mills — making profits on selling people highly addictive drugs — are certainly part of the problem.
It’s important, however, to note that doctors and physicians are also victims of the opioid epidemic. Anyone can become addicted to opioids, even if they know the risks and dangers.
Health professionals across the United States are not only struggling with addiction, but they are also having a hard time finding and receiving effective addiction treatment.
PHPs the Standard Since the 1970s
For decades, a system has been in place that, according to some doctors, can make drug addiction treatment less effective for physicians and other health care professionals: the Physical Health Program.
Most states have Physician Health Programs (PHP) to help health professionals who are struggling with addiction. In most cases, physicians who willingly participate in a PHP will be able to avoid formal complaints to the medical board in a confidential setting.
So what’s the problem? The main issue is that these programs link addiction treatment to retaining a license, which essentially holds a health professional’s career hostage if they do not undergo the treatment set out by the PHP. This means that the addiction treatment services available to this group are not tailored to each individual’s needs; rather, the programs are set out by the state with specific guidelines.
Most PHPs Do Not Allow MAT
One of the biggest programs with the guidelines and procedures of PHPs is that most do not allow certain types of treatment for addictions like medication-assisted treatment (MAT). MAT is a method of addiction care that utilizes medication along with behavioral therapy to help patients help with dangerous and uncomfortable withdrawal symptoms, suppress cravings or block a drug’s ability to give a high.
Rather than tailor programs to fit each individual, the drug addiction treatment methods are set out by each state’s PHP. So, if a particular state has a PHP that bans the use of medications that can help patients safely detox or maintain sobriety, then the participating health care professional may have to weigh their personal safety and recovery with losing their license.
Why Set Health Care Professionals Up for Failure?
Given that PHPs were created by physicians for physicians, why are they setting health care professionals who struggle with addiction up for failure? The answer to this question is complicated.
Part of the issue is that the PHPs are not current with best practices that have been developed over time. There is a misunderstanding or stigma surrounding the use of medications like buprenorphine or methadone, which are common in inpatient addiction treatment. According to some physicians, the ban stems from a misinformed idea that a non-medication approach is perhaps better than taking medication to treat addiction.
Authorities who set the guidelines for PHPs have a different perspective. They want to err on the side of caution, prohibiting practicing physicians from taking drugs that could result in a negative patient outcome. While this may be a valid concern, by denying the ‘gold standard’ of treatment that MAT can offer, PHPs may be setting up this group of people for failure. Quitting “cold turkey” can be dangerous, ineffective and can seriously compromise one’s ability to think and work. These guidelines, it seems, could result in harm to both doctors and patients.
Making MAT Gold Standard Addiction Treatment for All
Recently, physicians have been speaking out about the importance of health care workers not being left out of receiving effective, safe addiction treatment. Statistics show that health care professionals are actually a high-risk group: physicians are five times more likely to abuse prescription drugs than the general population.
MAT addiction treatment is recognized as the “gold standard” in addiction treatment and can go far in helping patients stop using and stay sober. Recovering from addiction is difficult enough without eliminating important tools like MAT treatment. Research suggests that MAT can drastically improve a patient’s chances of recovery — an important achievement for all, including doctors.
Anderson, Pauline. “Physician Health Programs: More Harm Than Good?” Medscape, August 19, 2015. Accessed September 30, 2019.
Simmons-Duffin, Selena. “For Health Workers Struggling With Addiction, Why Are Treatment Options Limited?” NPR News, September 6, 2019. Accessed September 30, 2019.
Physician Health Program. “What is a Physician Health Program?” Accessed September 30, 2019.
Abraham, Stephanie. “Signs and Symptoms of Addiction in Medical Professionals.” Michigan Health Lab, July 13, 2018. Accessed September 30, 2019.
Bart G. “Maintenance medication for opiate addiction: the foundation of recovery.” Journal of Addictive Diseases. Accessed September 30, 2019.