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Specificity of Blood Phosphatidylethanol (PEth) as a Marker for Alcoholic Beverage Consumption

Utilizing blood phosphatidylethanol (PEth) in abstinence monitoring programs (particularly with health professional, airline pilot, and/or other professional monitoring) as a means to detect relapse to alcoholic beverage use is a relatively new development over the past decade. PEth is a minor metabolite of ethanol formed when an enzyme, phospholipase D (PLD), binds ethanol to phosphatidylcholineRead More

Early Intervention

Physician health programs (PHPs) provide state disciplinary authorities (medical boards) what wellbeing committees (WCs) provide for hospital disciplinary authorities (medical executive committees). The former regarding licensure and the latter hospital privileges, both necessary for most physicians to practice. In the few states, like California, with no PHP, wellbeing committees take on added responsibilities. In statesRead More

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

“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

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

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