In partnership with IntelliGuard Intelligent Inventory Solutions
Being a doctor in a small town comes with its perks - patients have often become friends, and pre-op visits are spent catching up on news of wedding plans, graduations, and updates on who’s ahead in the little league. Sometimes, however, they’re met with a familiarity that doesn’t exactly match the wholesome intimacy above.
Like the time I was running through the basics with a patient who in a few minutes would be headed into surgery that I was on when his wife suddenly stopped me. “Where do I know you from?” she asked. After some thought, I remembered, her face was one in the sea of others that I had sat across from for the past few months. My patient’s wife was in my weekly meetings for Alcoholics Anonymous. “Is your first name Jodi?” she stirred me from my shame-fog.
“Yes,” I replied. I am an addict.
In 2019 I told my truth to an Editor at Marie Claire magazine. While I was brave enough to want to use my full name, those that I worked for weren’t - just another example of how the stigma of addiction and mental illness amongst medical professionals has tightened its grip on the industry. Since that article was published, I have seen the opioid epidemic worsen, and the open-door policy of hospitals remains the same. Don’t ask, don’t tell. And with my medical background having its seeds planted in the Navy, I am very used to operating under reticent circumstances. But not anymore. I can’t change what I did in the past, but I can change the future. So here I am, shedding my anonymity with the hopes of paving a path toward diversion prevention.
My story includes a spectacular fall from grace - no one in my town would have expected me to be a drug addict, and now here I was openly talking about my addiction with my patient’s wife. My choice in disclosing that information with them was the same then as it is now. We have a long, long way to go before the stigma is better. Admitting you are a drug addict or alcoholic is a scary thing to do for anyone, especially doctors. The constant pressures of perfection and expectation of excellence should no longer alter our understanding that we’re all humans first, regardless of our profession.
We need more of us to speak out to say that we can recover, and despite the odds, we do recover. For me, time and truth go hand in hand, and this is the best next step.
Historically with opiates, there’s a high relapse rate - it’s like an alcoholic working at a bar. Often re-entering the workplace is fraught with potential disaster. There has been a lot of progress, but we’re not there yet. There’s still so much disgrace surrounding physicians in recovery that the anxiety around how I would be perceived by my new colleagues and patients post-recovery was almost as bad as the worry surrounding handling the drugs that ruined me in the first place. If the stigma disappears, half the battle is won. I’m fortunate to say that the patient I mentioned above graciously allowed me to continue to be the practitioner for his case without any concern, but I can’t say that that has been the case for everyone. Since returning to the operating room, fentanyl has lost its power on me, but the inability to talk about the power it had with those I’m surrounded by has not.
Doctors in recovery who are enrolled in state physician health programs (PHP) can keep their medical licenses and practice in most situations as long as they comply and stay sober. However, apart from those involved in PHP and those who are lucky enough to find themselves working amongst an empathetic ally, support is hard to come by.
In fact, not all states have PHP programs, even though the model has shown remarkable results. A study published in the Journal of Substance Abuse in 2009 showed that out of 904 physicians surveyed, 72 percent continued to practice medicine. But with hundreds of people dying of opioid overdoses in the U.S. every day, I think it begs the question of why hasn’t another study been conducted in the last decade?
Until I needed the support, I had no idea what the PHP was, but for anyone who may need them, here is what you need to know:
- Almost all state medical boards now endorse complementary clinical programs for early detection, referral and monitoring of affected physicians (PHPs).
- The PHP contacts the diverting physician and lets them know there is a concern and the physician must stop work and undergo a clinical evaluation.
- For me personally, the interpersonal peer support and accountability that followed as a result of the PHPs diligence is a large reason for my recovery.
- While most states have a PHP program, there are several states that do not, putting many patients and practitioners at risk.
My weekly Caduceus meetings with other doctors, physician assistants, and respiratory therapists in recovery have been a safe space for the entirety of my extended recovery. We’ve discussed reintegrating into our new places of work and how the COVID-19 pandemic has triggered, tired, and tested our sobriety. I often sit and wonder who my non-addict physician friends are talking about the same things and how if we all had space to regularly debrief together, what that could do for those struggling.
While the system isn’t perfect, and it does have a long way to go, it isn’t for lack of trying. My experience with Georgia’s PHP got me to where I am now and is the sole reason I can continue practicing. In an army of former diverters, there must be others walking alongside us fighting for prevention. Investigators, educators, and medical boards must march forward together. In an industry full of humans that are called to heal others, we must first think of the moments in which we need to heal ourselves. Individuals like Kim New, JD BSN RN, have dedicated their careers to educating medical staff on how to prevent diversion and how to detect it quickly.
“I have worked addressing diversion for many years and have identified more than one friend of mine diverting, and I have seen first-hand the devastating impact diversion can have,” New said. “My focus is to help develop formal programs to address this serious issue. That first includes having a consistent, compassionate response process.”
What is most impactful to me about Kim’s dedication to the continued education surrounding this topic, and also how she injects everything she does with compassion first which is not dissimilar to the compassion of my patient, who allowed me to treat him after his wife and I shared our stories of sobriety.
The first step is listening, Healthcare Professionals: The Road from Diversion and Addiction to Prevention and moderated by Kimberly New - Founder of Diversion Specialists, where a panel of experts including myself, Vice President of Operations at Institute for Safe Medication Practices - Rita Jew, and Director of Pharmacy Services at Emory University Hospital - Tony Scott, work toward uncovering several paths that lead to diversion in the first place.
It is through this that we begin to understand the scope and magnitude the COVID-19 pandemic has on healthcare providers who may be struggling with substance abuse. It is said that the opposite of addiction is not an absence but it is connectedness - this past year has pulled us apart in ways that have changed practice and treatment patterns that will have direct impacts on those that are struggling and increase opportunities for diversion.
My choice in partnering with IntelliGuard on this journey does not stop at the webinar or even this blog series. It is rooted in a shared commitment, first and foremost, to patient safety. Furthermore, in order for prevention to truly be realized, corporations big and small need to do their part. IntelliGuard is not only doing that through providing a platform for me to tell my story but is paving a path with their own innovation technology aimed at improving the systems in place for diversion accountability. Like state-established PHPs and trailblazers like Kim, Rita, and Tony, IntelliGuard is ready for battle.
Ideally, with time, an army of practitioners, addicts, pharmacists, and patients will begin to march forward in lockstep with a shared mission. Our strong commitment to destigmatizing addiction and mental health will ultimately result in a collective effort toward preventing diversion. Through certain technologies and advancements, this will be possible.