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Relapse among Physicians with Substance Use Disorders

Studies have reported that the relapse rate of physicians with substance use disorders over a 5-year period following commencement of a monitoring agreement with a Physician Health Program (PHP) is about 20%.  This is an impressive but overly simplistic statistic. What is relapse? Are there different severities of relapse? Should relapse be considered a failureRead More

Top 8 Mistakes Made by Well-Being Committees and Physician Health Programs

In 2001 the Joint Commission, with input from the Federation of State Physician Health Programs (PHPs), developed standards that require hospitals to have functions similar to what the state PHPs provide for state licensing bodies. These functions include: Education (about problems that can cause impairment, primarily substance use disorders), Early Intervention, Referral for Evaluation andRead More

“Failing Up” – and the ASAM Criteria

It has become common in the treatment of substance use disorders to accept the idea of treating an individual at a lower (and less expensive) level of care with the plan that if they fail (i.e. relapse) that then, and only then, is a higher level of care warranted. This concept of “failing up” isRead More

Phone Intervention: Every Word Matters

During this time of social distancing, it seems appropriate to discuss remote (telephone) intervention. In 2011, we at the Alabama Physician Health Program, where I was then medical director, examined intervention outcomes over the previous 10 years. We found that of the 328 interventions that had been conducted, almost half, 161, were telephone interventions. InRead More

A Crisis of Physician Health in California

California was one of the first states to develop a program for early detection and treatment of physicians with substance abuse problems, but the program was closed in 2007. Now, California is one of the only states lacking such a program. The result has been catastrophic for many physicians and their patients. Substance use disordersRead More

Physician Health Programs Are Important: Encouraging Early Referrals

(While addressing Physician Health Programs specifically in this blog, the same principles can apply to all types of professional health programs for all the other health professions (dentists, nurses, judges, attorneys, pilots, etc)). Not everyone knows why Physician Health Programs are important. A medical board in a neighboring state without a PHP once asked meRead More

Specificity of Phosphatidylethanol as a Marker for Alcoholic Beverage Consumption

Utilizing blood phosphatidylethanol (PEth) testing as a means to detect beverage alcohol use vs abstinence among licensed professionals and others is a relatively new development. Phosphatidylethanol is a minor metabolite of ethanol formed when an enzyme, phospholipase D (PLD), binds ethanol to phosphatidylcholine lipids in cell membranes, including red blood cells. Over 48 homologues (similarRead More

Addiction and Crime

It is not a good idea to treat someone for an illness they do not have. In fact, it could be considered unethical. We have a successful model now in the professional health world for treating addiction as an illness. And if someone has that illness they should be diagnosed and treated. And there areRead More

Does AA Work?

Google AA (Alcoholics Anonymous) and you find a lot of negative opinions about it online. “AA is a cult.” “AA only has a 5% success rate.” “AA is an irrational “faith based” program.” “AA is a dangerous playground for violence-prone members.” “AA doesn’t work.” “The pseudo-science of AA.” So, if it does not work thenRead More

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