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Indian Journal of Medical Sciences, Vol. 63, No. 7, July, 2009, pp. 308-309 Letter To Editor Substance abuse among medical professionals: A way of coping with job dissatisfaction and adverse work environments? Bhan Anant Independent Researcher, Bioethics and Public Health, Pune Code Number: ms09055 PMID: 19700912 Sir, The article by Kaur et al.[1] highlights the experiences among medical professionals which result from stressful and unpleasant work environment, and projects a significant level of unhappiness with regard to salary and low level of professional satisfaction among doctors in a tertiary care hospital. As one of the first studies in the area in the country, it provides important pointers about how doctors perceive their professional milieu. The study could have been strengthened by looking at prevalence and pattern of substance abuse among doctors and its correlation with the findings about job satisfaction and work environment. Substance abuse is now recognized as a major problem among medical students and doctors, but it has not been adequately researched, a fact that finds support in a recent journal editorial lamenting the ′ostrich-like response′ of the medical community to the issue. [2] Substance abuse involves overuse of, and dependence on, a drug, chemical or product - this could include tobacco (oral or smoked), alcohol, prescription medications and illicit narcotics. A cross-sectional study in Orissa among medical students in 3 medical colleges found prevalence of current tobacco use to be 8.7%. [3] Research on medical professionals published from Kerala reported that among the male respondents in the study sample, 15.1% of medical school faculty, 13.1% of physicians and 14.1% of medical students were tobacco smokers. [4] A study among 2135 medical students from 76 medical colleges attending an inter-college event found current alcohol use of 7.1% and current tobacco (oral or smoked) use of 6.1% reported by respondents; lifetime use of illicit substances was reported by 6.7% of the respondents. [5] A newspaper report from Pune published in June 2009 brought forth the stories of a few female medical professionals undergoing de-addiction in the city to tackle their abuse of prescription drugs; [6] the reasons for the addiction identified in the report included occupational stress and heavy workload. Given that the data (though limited) suggests a significant substance abuse problem among medical professionals, we need to look at factors that might be responsible for addictions developing. Common use of tobacco (especially smoking) and alcohol among their peers might make it easy for medical professionals to get initiated into substance use and promote subsequent addiction. The easy availability of prescription medication such as opiates and central nervous system (CNS) depressants in hospitals and clinics (and the ability to self-medicate/ prescribe) is conducive for medical professionals′ substance abuse. Stress, long busy hours at work and unfavorable work conditions might be contributing to doctors turning to (or increasing the quantum of their) substance abuse as a coping mechanism to ′de-stress.′ The links between dissatisfaction with jobs/ environment at workplace among medical professionals and substance abuse need to be thoroughly researched. This will help in addressing the need for more favorable work conditions, as well as in identifying responses to factors influencing substance abuse among health care providers. Doing so will help us promote better medical practice and healthier work conditions and life styles for medical professionals in the country. Acknowledgment Comments and editorial suggestions by Dr. Niki Shrestha are gratefully acknowledged. References
Copyright 2009 - Indian Journal of Medical Sciences |
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