HCPs in pharmacotherapeutic treatment for opioid addiction should not return to clinical practice
Many health care professionals (HCPs) have easy access to controlled medications and the diversion and abuse of drugs among this group may be as high as 10%. Controversy surrounds the safety of allowing addicted HCPs to return to clinical practice while undergoing medical treatment with opioid substitution therapy such as buprenorphine. In the March issue of Mayo Clinic Proceedings, Heather Hamza, CRNA, MS, of the Department of Anesthesiology, Los Angeles County Medical Center at the University of Southern California, and Ethan O. Bryson, MD, of the Departments of Anesthesiology and Psychiatry, Mt. Sinai Medical Center, New York, review the evidence and call for abstinence-based recovery instead.
"Because health care professionals are typically engaged in safety-sensitive work with considerable consequences when errors occur, abstinence-based recovery should be recommended until studies demonstrate that it is safe to allow this population to practice while undergoing opioid replacement therapy," says Dr. Bryson.
Buprenorphine is not completely free of abuse potential. Ms. Hamza and Dr. Bryson comprehensively reviewed a number of studies that examine the risk. "Opioid-addicted HCPs are masters of drug diversion. In this population, intelligence can be used to cleverly circumvent narcotic accountability and drug substitution. It does not seem reasonable to prescribe this medication to an HCP with a history of drug addiction," Ms. Hamza says.
Many trials have assessed psychomotor performance, decision-making ability, and neurocognitive functioning under the influence of buprenorphine. "Most found some degree of impairment when participants were subjected to a variety of tests designed to assess particular nuances of higher cerebral function," Dr. Bryson reports. "Studies using standardized patients or operating room simulation, presenting realistic scenarios that require rapid analysis and action, complex decision making, and fine motor skills are needed."
Most state medical and nursing societies provide professional health programs (PHPs) which allow for the eventual return of addicted practitioners to clinical practice. Many were unavailable or declined to comment on their policies regarding the re-entry of HCPs while undergoing buprenorphine therapy, an indicator of the controversy surrounding this issue. However, published literature suggests that the success rates of PHPs is higher than in other populations, and most PHPs that use an abstinence-based model for physicians in recovery report success rates in excess of other programs.
"Abstinence from all potentially addictive drugs remains the criterion standard for HCPs in recovery," Hamza and Bryson conclude. "HCPs are engaged in safety-sensitive work that requires vigilance and full cognitive function. We therefore recommend abstinence-based recovery until studies with this specific population document that highly safety-sensitive tasks can be performed without deterioration in performance."
Journal reference:
Mayo Clinic Proceedings
Provided by
Elsevier
-
Suboxone is most effective in treating painkiller addiction
Nov 07, 2011 |
not rated yet |
0
-
Buprenorphine treatment produces improved outcome for babies born addicted
Dec 09, 2010 |
not rated yet |
0
-
Recovery housing and treatment programs reduce relapse among recovering opioid addicts
Feb 28, 2012 |
not rated yet |
0
-
Making sense of addiction terminology
Feb 03, 2012 |
not rated yet |
0
-
Collaborative care shown to be successful for patients with opioid addictions
Mar 14, 2011 |
not rated yet |
0
-
Motion perception revisited: High Phi effect challenges established motion perception assumptions
Apr 23, 2013 |
3 / 5 (2) |
2
-
Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update)
Apr 02, 2013 |
4.5 / 5 (11) |
5
-
The visual system as economist: Neural resource allocation in visual adaptation
Mar 30, 2013 |
5 / 5 (2) |
9
-
Separate lives: Neuronal and organismal lifespans decoupled
Mar 27, 2013 |
4.9 / 5 (8) |
0
-
Sizing things up: The evolutionary neurobiology of scale invariance
Feb 28, 2013 |
4.8 / 5 (10) |
14
-
Enthalpy of reaction
3 hours ago
-
Harmonic oscillation problem -Dancing pot
3 hours ago
-
Ultracapacitor to power electromagnet?
4 hours ago
-
Confusion in Electro Statics
4 hours ago
-
simple gravity question
6 hours ago
-
I need help understanding the Fourier components of a square wave
7 hours ago
- More from Physics Forums - Classical Physics
More news stories
Beer-industry advertising guidelines: Rating panels may help industry assess itself
In order to avoid exposing vulnerable groups such as children and young adults to alcohol advertising, industry groups have developed their own self-regulation guidelines. However, these guidelines have been criticized for ...
Addiction
May 17, 2013 |
not rated yet |
0
College women exceed NIAAA drinking guidelines more frequently than college men
In order to avoid harms associated with alcohol consumption, in 2009 the National Institute on Alcohol Abuse and Alcoholism issued guidelines that define low-risk drinking. These guidelines differ for men and women: no more ...
Addiction
May 17, 2013 |
not rated yet |
0
|
Individuals who drink heavily and smoke may show 'early aging' of the brain
Treatment for alcohol use disorders works best if the patient actively understands and incorporates the interventions provided in the clinic. Multiple factors can influence both the type and degree of neurocognitive abnormalities ...
Addiction
May 17, 2013 |
not rated yet |
0
|
Researchers analyze how Spanish smoking relapse booklets are distributed
Researchers from Moffitt Cancer Center and the University of South Florida have evaluated how Florida health care and social service agencies distribute "Libres para Siempre", a Spanish smoking relapse prevention booklet ...
Addiction
May 17, 2013 |
not rated yet |
0
No significant change seen in overall smokeless tobacco use among US youths
Tobacco use remains the leading preventable cause of death and disease in the United States. Declines in smoking among youths were observed from the late 1990s. "However, limited information exists on trends in smokeless ...
Addiction
May 14, 2013 |
not rated yet |
0
Computer model predicts when viruses become infectious
A new computer model could help scientists predict when a particular strain of avian influenza might become infectious from bird to human, according to a report to be published in the International Journal Data Mining an ...
Atherosclerotic disease heredity mapped in nationwide study
Researchers at Lund University in Sweden have mapped the significance of heredity for common forms of atherosclerotic disease. No studies have previously examined whether different forms of the disease share heredity.
Impossible to predict outcome in China's bird flu outbreak, WHO says
It is impossible to predict the evolution of China's human H7N9 bird flu outbreak as researchers are still trying to understand the source of human transmission, the head of the World Health Organisation said Monday.
FDA has safety concerns on Merck insomnia drug
Federal health regulators say an experimental insomnia drug from Merck can help patients fall asleep, but it also carries worrisome side effects, including daytime drowsiness and suicidal thinking.
Neurons that can multitask greatly enhance the brain's computational power, study finds
Over the past few decades, neuroscientists have made much progress in mapping the brain by deciphering the functions of individual neurons that perform very specific tasks, such as recognizing the location ...
Anabolic steroids may affect future mental health
There is a link between use of anabolic-androgenic steroids and reduced mental health later in life. This is the main conclusion of a new study on elite male strength athletes that researchers from the University of Gothenburg ...