Substance Use Disorders in Healthcare: Why It Happens and How to Seek Help

Hey there,

If you’ve worked in healthcare long enough, you’ve probably seen the whispers or heard the stories. Maybe it’s a colleague who seemed off during a shift, or someone who abruptly left their position with little explanation. Substance use disorders among healthcare professionals is a topic we don’t talk about enough, but it’s something that needs our attention. So, let’s have an honest conversation about why it happens and what to do if you or someone you know needs help.

Why It Happens

First, let’s bust a myth: substance use disorders don't happen because someone is “weak” or “lacking willpower.” Healthcare professionals experience substance use disorders at the same rates as the general population.  However, there are a few reasons healthcare workers may be at higher risk:

1. Stress and Burnout: Healthcare is rewarding but also incredibly demanding. Long hours, high-stakes decisions, and emotional exhaustion can leave us looking for a way to cope. For some, substances might seem like an escape.

2. Access: The medications healthcare professionals work with can be tempting, especially when they’re within arm’s reach. Combine that with their medical knowledge, and it can feel like a slippery slope.

3. Stigma and Fear: The pressure to appear “perfect” in their roles can make it hard to ask for help. Many fear losing their license, their job, or their colleagues’ respect if they admit to possibly having a problem.

4. Chronic Exposure to Trauma: Constantly dealing with life-and-death situations can take a toll. Substances might feel like a way to numb the pain.

Signs to Look For

Recognizing the signs of substance use disorders in yourself or a colleague is the first step. Here’s what to watch for:

• Changes in behavior, like mood swings or isolation

• Frequent errors or forgetfulness

• Unexplained absences or tardiness

• Physical signs like bloodshot eyes or shaking hands

• Patients reporting inadequate pain relief, which could indicate diversion

How to Seek Help

If you’re reading this and thinking, "This might be me," or if someone comes to mind, know this: help is available, and recovery is possible. Here’s what you can do:

1. Contact OhioPHP: OhioPHP exists to provide non-punitive, confidential support. We can guide you through the process of getting help while protecting your career. The State Medical Board of Ohio (SMBO) developed a confidential monitoring program for all licensees and applicants. This program is a confidential path for individuals to seek help for burnout, mental health, substance use disorders, or other medical conditions. The CMP is a therapeutic alternative to regulatory awareness. To find out more, visit https://www.ohiophp.org/smbo

2. Know Your Rights: In many cases, seeking help proactively can protect your license and career. Programs like OhioPHP are designed to support, not punish you.

3. Reach Out to a Trusted Colleague or Supervisor: Talking to someone who understands the pressures of healthcare can help.

4. Look Into Peer Support Groups: Groups like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) often have meetings specifically for healthcare professionals.

5. Utilize Employee Assistance Programs (EAPs): Many healthcare organizations offer free and confidential counseling services through EAPs.

Supporting a Colleague

If you’re concerned about someone else, it can be hard to know what to do. Here’s a simple approach:

1. Choose a suitable time and confidential location

2. Plan a straightforward message

3. Be honest and specific

4. Express your feelings about what you’ve observed

5. Give your colleague an opportunity to respond

6. Encourage them to call OhioPHP

7. Follow-up with them

Some things to keep in mind when approaching a colleague who may need help:

• Be mindful of your tone and body language

• Approach conversation with empathy and concerns, avoiding accusatory language or trying to diagnose

• Respect their privacy

• Focus on listening more than talking (actively listen to their concerns without interrupting)

• *If their situation seems severe or beyond your capacity to support, encourage them to seek professional help, such as from OhioPHP

Avoid:

• Pressuring them to share more than they are comfortable sharing

• Making assumptions about their mental health issues

• Offering unsolicited advice or trying to "fix" their problems

• Sharing their personal information with others without their consent

• Minimizing their feelings or dismissing their concerns

Here are some examples of things you could say:

Keep it positive: “How about trying a few alcohol-free nights each week?”

Get specific: “I’m worried about your drinking because I smelled alcohol on your breath last week.”

Offer support: “I know that drinking less is hard for you. How can I support you?”

Be flexible: “I can see that you’re not ready to talk about this yet. I’m here for you whenever you are ready.”

Offer resources: www.ohiophp.org/substance-use

Let’s Change the Conversation

Substance use disorders in healthcare isn’t a personal failing—it’s a sign that someone needs support. As a community, we can create a culture where asking for help is seen as a strength, not a weakness. If you or someone you know is struggling, take the first step today. Recovery is possible, and you don’t have to face it alone.