The following story has been edited to protect the identity of the doctor who lived it
I am an anesthesiologist who initially became addicted to Fentanyl in 1993. It was a brief “run” and I ended up in a month-long inpatient program. Then I participated in the Medical Board Diversion Program for 6 1/2 years. I went back to work after that first month, went to AA and NA meetings like I was supposed to, and had a pretty uneventful time in Diversion. It was there that I first met my group facilitator, a psychotherapist who had expertise in helping addicted and/or alcoholic health care workers. I was near the end of my time in monitoring, had no desire to drink or use, and saw no reason to continue attending AA.
Fast forward 15 years…
I am a very anxious, unhappy 55-year-old physician with a wife, 2 kids, and a big mortgage. I’m really just keeping my head above water, and depression has become a big part of my life. I get injured in a horseback riding accident, have surgery and get re-exposed to narcotics as a patient for the first time in many years. I become aware I’m finding that peaceful, warm feeling every time I am given my pain medicine. I keep using more…long after it’s needed. In thinking only an addict can understand, I decide not to forge prescriptions or beg for more pain medication but to start using IV Fentanyl again.
The nightmare was far worse this time. Operating Room nurses confronted me just a couple of weeks into my return to work and I had no defense. I was a narcotic addict and I could not stop. In the worst depression I had ever known, I had to tell my wife and teenage kids the incredibly painful and shameful truth. I wanted to die. My wife called my former group facilitator and within a day I was at the Betty Ford Center. It was to be at least three months of inpatient treatment this time. This time it shook me to my core.
My group facilitator and PAG were there for me when I was discharged. I learned that the Diversion Program had been terminated, and it took me a while to understand the ramifications. That layer of anonymous protection for physicians with the disease of addiction was gone. If I had been reported to the Board or had been stopped for a DUI, there would be significant consequences. PAG was now the best option if I wanted to:
- Work again
- Develop and maintain a documented history of recovery by giving random urines and having regular “face time” with an experienced counselor, and
- Most importantly — improve my chances to survive.
I can only speak for myself. I need the accountability of random urines. I need to be in a long term group of recovering physicians led by an experienced psychotherapist with solid addiction experience. My employers, coworkers, and patients want – and deserve – to know I am ‘clean’ and working a program of recovery. For myself and others, PAG has been a safe place to share with other health care workers. Without PAG there would be no structured, recognized program for health care providers to return to in California. It can’t solve all of the problems a physician with this disease now encounters, but it is clearly the best alternative available.
Recovery from the disease of addiction will be a lifetime process and, at times, very difficult. AA has been a blessing for me this time around. But there are unique challenges that face a licensed health care worker in California. It might be possible to survive those challenges if you are very, very fortunate. For the vast majority of us, I have not the slightest doubt that PAG offers the best chance to show a documented program of recovery, which is essential for hospitals, medical groups, insurance carriers, state authorities, etc. More importantly, I believe it has been vital for my ongoing recovery from this powerful disease. I want every tool available when I am dealing with something that could at least destroy my career, family, and mental health. At worst, it can end my life.
I am thankful to Pacific Assistance Group and to my group facilitator for being there for me. From someone who experienced the Diversion Program and appreciates what a mistake, it was to terminate it, I am certain the PAG program offers the most protection to the physician in the early years of recovery. I would not hesitate to recommend it if I saw a physician, dentist, PA, or pharmacist in trouble. It does work.
An Anesthesiologist in Recovery
