Burnout and Alcohol Abuse/Dependence Among U.S. Medical Students.
"To explore the relationship between alcohol abuse/dependence with burnout and other forms of distress among a national cohort of medical students."
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"To explore the relationship between alcohol abuse/dependence with burnout and other forms of distress among a national cohort of medical students."
"To investigate the prevalence and temporal patterns of hazardous drinking and risk factors during medical school for future hazardous drinking among doctors."
"To determine the point prevalence of alcohol abuse and dependence among practicing surgeons."
"Substance use disorders among physicians are important and persistent problems. Considerable debate exists over whether use of major opioids, especially among anesthesiologists, is associated with a higher relapse rate compared with alcohol and nonopioids. Moreover, the risk factors for relapse with current treatment and monitoring strategies are unknown."
This article reviews scientific advances in the prevention and treatment of substance-use disorder and related developments in public policy. In the past two decades, research has increasingly supported the view that addiction is a disease of the brain. Although the brain disease model of addiction has yielded effective preventive measures, treatment interventions, and public health policies to address substance-use disorders, the underlying concept of substance abuse as a brain disease continues to be questioned, perhaps because the aberrant, impulsive, and compulsive behaviors that are characteristic of addiction have not been clearly tied to neurobiology. Here we review recent advances in the neurobiology of addiction to clarify the link between addiction and brain function and to broaden the understanding of addiction as a brain disease. We review findings on the desensitization of reward circuits, which dampens the ability to feel pleasure and the motivation to pursue everyday activities; the increasing strength of conditioned responses and stress reactivity, which results in increased cravings for alcohol and other drugs and negative emotions when these cravings are not sated; and the weakening of the brain regions involved in executive functions such as decision making, inhibitory control, and self-regulation that leads to repeated relapse. We also review the ways in which social environments, developmental stages, and genetics are intimately linked to and influence vulnerability and recovery. We conclude that neuroscience continues to support the brain disease model of addiction. Neuroscience research in this area not only offers new opportunities for the prevention and treatment of substance addictions and related behavioral addictions (e.g., to food, sex, and gambling) but may also improve our understanding of the fundamental biologic processes involved in voluntary behavioral control.
"To evaluate the effectiveness of US state physician health programmes in treating physicians with substance use disorders."
"Physicians with substance use disorders receive care that is qualitatively different from and reputedly more effective than that offered to the general population, yet there has been no national study of this distinctive approach. To learn more about the national system of Physician Health Programs (PHPs) that manage the care of addicted physicians, we surveyed all 49 state PHP medical directors (86% responded) to characterize their treatment, support, and monitoring regimens."
"In its position paper addressing physician impairment and rehabilitation (1), the American College of Physicians (ACP) Ethics, Professionalism and Human Rights Committee thoughtfully considers the imperfectly marked path that physicians are asked to tread: identify impairment, provide access to care, ensure patient safety, and rehabilitate. These are the responsibilities of physicians as professionals (monitoring oneself and one's peers) and as leaders (supervising highly trained persons)."
Opioids have become a full-blown national crisis of epidemic proportions, killing 130 people each day. Drug overdose is now the number-one cause of death for Americans under 50. One doctor at the top of her game—who knew the risks better than anyone—almost became another statistic.
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