As the saying goes, “What’s good for the goose is good for the gander,” but when it comes to the subject of addiction, I’ve noticed a huge disparity in the way doctors who suffer with addiction issues are treated compared to everyone else.

Ignorance is Not Bliss

What most people don’t realize or don’t know is that when a doctor has substance abuse issues here’s what generally happens—and it happens quickly: The physician is mandated into treatment. Most treatment facilities expound abstinence and introduce their clients to the twelve-steps. When worked and applied to one’s life, the twelve-steps work remarkably well. After treatment, doctors are further monitored for three to five years and they’re subject to random urine tests. In addition, physicians are required to attend at least three Alcoholics Anonymous (AA) meetings a week, and they are required to have a paper signed to prove attendance. If they skip a urine test, additional time is tacked on to their required “sentence.”

I have yet to see many doctors fail to recover with this recipe—but there are exceptions. One doctor just couldn’t let go of his control and surrender to the disease that had pummeled his life. He kept relapsing and eventually lost his medical license—for good. When I met him he drove a cab, and showed up sporadically to meetings. He has since disappeared; perhaps he moved, perhaps he died … perhaps he’s still drinking. I can’t say with any certainty where his journey has led.

Let’s contrast the above scenario to what happens to people who visit the emergency department (ED) for any number of reasons, many visits by the way are because of alcohol and/or drugs. In 2011 it was estimated that over 2.5 million ER visits could be attributed to illegal “drug abuse or misuse.” During that same year, available statistics tell us that 4o% of ED visits by those aged twenty or younger were due to alcohol abuse. Everyone knows that those statistics have only dramatically increased due to the heroin epidemic.

Why Do Doctor’s Treat Their Peers Different Than Their Patients?

Here’s what happens to the average person: Most likely the medical professionals will collect a urine sample to perform a toxicology screen. Far too often, drugs, alcohol or a plethora of substances are found in the person’s system.  Doctors should stop right there and address the substance abuse, but they don’t. The patient complains of depression and anxiety. They feel stressed and maybe even suicidal. What do the doctors do? More often than not, the doctors will get busy and fill out a pink slip to send that person to the psychiatric ward on a 72 hour hold if they’re suicidal, or they’ll medicate with Ativan or Valium to stave off a panic attack before they discharge the person home.

Questions You Should Wonder About

What I’ve noticed after working in the ED and psychiatric wards for the last twenty-four years is that the repeat business is strong. Doctors have little incentive to ask or address the alcohol/drug abuse, or perhaps they just don’t know what to do, so they don’t bother to ask. According to one source, 80% of doctors fail to ask about a patient’s drinking. Why is this? Could it be that repeat business is good for the hospital’s bottom line? Could it be that pharmaceutical companies offer added incentives for doctors to prescribe more medications, even though that practice was supposed to have been discontinued? Could it be that the medical community doesn’t understand addiction and therefore ignores the problem?

We need to start asking questions. Why should doctors get to recover from substance abuse while their patients stay trapped in lives where they can only half function? I see too many patients exposed to medication regimens that looks something like this: Seroquel, Buspar, and Zoloft to be taken twice daily. Effexor, Seroquel, and Neurontin to be taken daily or twice daily at varying doses. I cannot understand why any physician would treat depression with an antidepressant and anti-psychotics, such as Seroquel, especially, if a person is continues to drink alcohol—a depressant. The many doctors I know who have substance abuse issues were not prescribed medication when they left rehab. They are clean. They are sober–so why don’t patients get the same treatment?

Lives and careers are at stake. I’ve worked with many women over the years who took all sorts of medication and could only half function; bright, talented people who could no longer work a full time job due to their depression. A large number of those people with debilitating depression also drank alcohol or took handfuls of prescription medication.

A new life and recovery only came once they decided to address their underlying substance abuse issues. Once sober, it’s been my experience that most all returned to full-time careers. They got off of the medication. We need to change the way we do things. If doctors deal with doctors by using the twelve-steps, I think they should deal with the general public in the same way so more people would have the benefit of getting their lives’ on track. We are losing a great deal of brilliance and talent to not only illicit drugs, but alcohol and prescription medication, and this must change.