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ECONOMICS, EDUCATION, AND HEALTH SYSTEMS RESEARCH

Substance Abuse Among Physicians: A Survey of Academic Anesthesiology Programs

John V. Booth, MB ChB, FRCA^*, Davida Grossman, MD, Jill Moore, BS, Catherine Lineberger, MD^*, James D. Reynolds, PhD^*, J. G. Reves, MD^*, and David Sheffield, PhD

*Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina; West Jersey Anesthesia Associates, Marlton, New Jersey; School of Medicine, East Tennessee State University, Johnson City, Tennessee; and Division of Cardiology, Department of Psychology, Staffordshire University, Stoke, United Kingdom

Address correspondence and reprint requests to John V. Booth, MB, ChB, FRCA, Box 3094, Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710. Address e-mail to booth006{at}mc.duke.edu

Efforts to reduce controlled-substance abuse by anesthesiologists have focused on education and tighter regulation of controlled substances. However, the efficacy of these approaches remains to be determined. Our hypotheses were that the reported incidence of controlled-substance abuse is unchanged from previous reports and that the control and accounting process involved in distribution of operating room drugs has tightened. We focused our survey on anesthesiology programs at American academic medical centers. Surveys were sent to the department chairs of the 133 US anesthesiology training programs accredited at the end of 1997. There was a response rate of 93%. The incidence of known drug abuse was 1.0% among faculty members and 1.6% among residents. Fentanyl was the controlled substance most often abused. The number of hours of formal education regarding drug abuse had increased in 47% of programs. Sixty-three percent of programs surveyed had tightened their methods for dispensing, disposing of, or accounting for controlled substances. The majority of programs (80%) compared the amount of controlled substances dispensed against individual provider usage, whereas only 8% used random urine testing. Sixty-one percent of departmental chairs indicated that they would approve of random urine screens of anesthesia providers.

IMPLICATIONS: This survey indicates that the frequency of controlled substance abuse among anesthesiologists has changed little in the past few years, despite an increase in the control and accounting procedures for controlled substances as well as increased mandatory education.

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