Results: Six hundred and one physicians had evidence of substance use disorder after completion of training, with an overall incidence of 0.75 per 1,000 physician-years (95% CI, 0.71 to 0.80; 0.84 [0.78 to 0.90] in men, 0.43 [0.35 to 0.52] in women). The highest incidence rate occurred in 1992 (1.79 per 1,000 physician-years [95% CI, 1.12 to 2.59]). The cumulative percentage expected to develop substance use disorder within 30 yr estimated by Kaplan–Meier analysis equaled 1.6% (95% CI, 1.4 to 1.7%). The most common substances used by 353 individuals for whom information was available were opioids (193 [55%]), alcohol (141 [40%]), and anesthetics/hypnotics (69 [20%]). Based on a median of 11.1 (interquartile range, 4.4 to 19.8) yr of follow-up, the cumulative proportion of survivors estimated to experience at least one relapse within 30 yr was 38% (95% CI, 31 to 43%). Of the 601 physicians with substance use disorder, 114 (19%) were dead from a substance use disorder–related cause at last follow-up.
Conclusions: A substantial proportion of anesthesiologists who develop substance use disorder after the completion of training die of this condition, and the risk of relapse is high in those who survive.
What We Already Know about This Topic:
Substance use disorders among anesthesiologists are common and hazardous to both the involved physicians and their patients
The incidence of substance abuse among U.S. anesthesiologists remains unclear, as does the relapse risk and consequent mortality
What This Article Tells Us That Is New:
The estimated cumulative 30-yr incidence of substance abuse among graduates of U.S. residency programs is about 1.6%, with opioids and alcohol being the most commonly abused substances
A substantial proportion of anesthesiologists who develop substance use disorder die of the condition, and the risk of relapse is high in those who survive at approximately 40%