Some Health Workers Have Limited Options for Treatment

We like to think that people who work in these types of helping professions are somehow immune from substance abuse, when they may be more at risk than the general population. The combination of long working hours, stress and access to many types of addictive medicines may play a role in some people developing an addiction. For others, the addiction started while they were studying for their role in healthcare.

Physician Health Program for Healthcare Workers

When doctors and other health workers develop a problem with addiction, where do they turn for help? In many instances, they are referred to a Physician Health Program (PHP). These state-run programs were developed in the 1970s to help doctors recover from addiction. Originally developed by doctors, these programs are now open to others in the healthcare field.

Doctors and others are encouraged to pursue this treatment because PHPs work with state licensing boards. If the healthcare worker successfully completes the treatment and monitoring plan, the PHP will recommend to the licensing board that the healthcare worker be relicensed. This is a definite incentive for people in this career field.

PHP Critics Point Out Very Few Will Authorize MAT

Critics of PHPs have pointed out that for a number of reasons these programs don’t allow medical professionals to undergo medical-assisted treatment (MAT), which is considered the best option available. MAT is a combination of professional counseling and a prescription for either methadone or buprenorphine. Both of these medications are opioids; however, instead of creating a high for users they suppress cravings for heroin, fentanyl and other drugs in this class.

Naltrexone is another medication that may be used to treat addiction. It works by blocking opioids’ action.

Dr. Sarah Wakeman, who works at Harvard and the Massachusetts General Hospital Substance Use Disorder Initiative, said that the majority of PHPs don’t refer their clients to programs that include medication as part of their treatment program. She noted that this is a problem, citing stigma as well as a misunderstanding of the underlying role of medications in addiction treatment.

Cognitive Concerns About Addiction Medications from PHPs

For their part, PHPs say that there are some concerns that healthcare workers who are on a MAT regimen may have cognitive issues due to the medication part of their treatment. Certain licensing boards and regulators don’t want the medications being used and the “in-patient treatment program without medication treatment” model has already been successful. For people working in careers where safety of others is paramount, such as healthcare workers, pilots, etc., avoiding medications is seen as the safest, and for the time being, best option.