Gary D. Carr, MD, says no physician treating diabetes would ever tell a patient, “Here’s your insulin. Don’t eat chocolate cake. Have a good life.” So he wonders why it seems acceptable to send a patient with a substance use disorder to a world-class treatment center, only to tell that person at the end of the stay, “Don’t drink. Go to meetings. Have a good life.”
“That’s a great failing we’ve had in this field,” says Carr, medical director of a Mississippi nonprofit network that assists physicians who have substance use problems or other impairing illnesses. At next month’s National Conference on Addiction Disorders (NCAD) in Washington, D.C., Carr will suggest in a presentation that a system of treating impaired physicians that emphasizes long-term monitoring can work for individuals from all walks of life.
Carr’s Sept. 8 session at the Sept. 8-11 conference will feature research data from Project Blue Print, involving an examination of 36 state “physician health programs” in which physicians receive treatment and ongoing monitoring that allows them to resume practice safely. The research showed that 78 percent of 904 doctors in the studied programs completed an average of 7.2 years of monitoring without relapse.
“Those are just over-the-top numbers for a chronic, progressive disease that kills people,” says Carr.
A skeptical argument often goes that physicians are a special case because the threat of losing a lucrative profession they have worked so long to pursue gives them extra motivation to stay sober. But Carr believes most everyone has something similar in their life that they value, and that is what the treatment system must identify and tap into.
“The plumber has a good job and doesn’t want to lose it,” he says. “Or he’s got a great wife.”
Carr says the field needs to analyze what it is providing to groups such as physicians and airline pilots but not to others. Then it can determine how to overcome barriers to a more widespread application of a treatment model that is based on accountability.
He believes that post-treatment monitoring needs to involve more than verifying whether a patient has located a sponsor. “We need to ask, ‘Who is your addiction professional?’” he says. He adds that treatment organizations need a dedicated staff for ongoing monitoring. “It’s a full-time job,” he says.
The NCAD meeting is being produced by Vendome Group, publisher of Addiction Professional, as an event combining treatment, administration, design, technology and other information for addiction professionals. Participating associations in NCAD are NAADAC, the Association for Addiction Professionals (which will now hold its annual meeting under the NCAD title), the National Association of Addiction Treatment Providers (NAATP) and the International Coalition for Addiction Studies Education (INCASE). For more information about the conference, visit www.ncad10.com.
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