Why physicians misuse prescription drugs

In a study of physicians with substance misuse issues, the physicians reported a variety of reasons for their misuse of prescription drugs, including pain control, emotional distress, stress management, recreational reasons and avoidance of withdrawal. These findings were published in the September/October issue of Journal of Addiction Medicine.

Lisa J. Merlo, PhD, MPE, of the University of Florida in Gainesville, and her colleagues listened to the focus group discussions of 55 physicians who were being monitored by their states because of substance misuse. They transcribed each of nine group sessions and then identified major themes.

The 55 physicians were from different specialties and predominantly white men. Of those 55, 38 reported a lifetime history of prescription drug misuse, while others said they only used alcohol and/or illegal drugs. All of the 38 who misused prescription drugs admitted to a history of alcohol use or illegal drug use. The three types of prescription drugs they reported misusing were opiates, sedatives and stimulants.

Many physicians who admitted to misusing prescription drugs for pain said they suffered severe pain after surgeries or trauma and that use led to an addiction. Others said as their addiction worsened, they switched to other medications.

Some of the participants also acknowledged long histories of anxiety or depression, which the drugs they took treated. Many also said they turned to medications during times of extreme stress or fatigue.

Still others admitted using prescription medications to get high or to reverse the effects of other drugs. Some also used the medications to avoid withdrawal symptoms as they attempted to get clean.

Although the study involved a small sample of participants who were being monitored and were overwhelmingly white and male, the authors argued that their research allowed for honesty and in-depth data.

“Prevention efforts targeting prescription drug misuse among physicians should be initiated during medical training, with continuing education requirements throughout the physicians’ careers,” they wrote.