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«One of my patients always had a breathalyzer with him – if he drank in the evening, he checked himself in the morning. Depending on the result of the measurement, he decided whether he could go to the hospital or not. ” With prof. Jan Chodkiewicz, head of the Department of Psychoprophylaxis and Psychology of Addiction at the Institute of Psychology of the University of Lodz, we talk about alcoholic doctors.
- Why Do Doctors Abuse Alcohol? Prof. Chodkiewicz says that three factors are usually decisive: stress, exhaustion and easy access to alcohol
- Doctors addicted to alcohol rarely choose therapy – they try to heal themselves
- The psychologist says that doctors rarely drink on duty, more often after returning home: – They drink according to the schedule and keep their finger on the pulse
- More information can be found on the Onet homepage.
Zuzanna Opolska, Medonet: Professor, I heard that Polish doctors no longer drink, prefer opioids …
Prof. Jan Chodkiewicz: We are really only in the area of presumptions. We do not have representative studies for doctors that would show which addiction is dominant among them. Traditionally, and many therapists will confirm it, alcohol is still a big problem. Do more doctors look into the glass or the medicine cabinet, I am not able to answer this question.
They are not afraid of such research abroad – what is holding us back? Reflection that we are treated by alcoholics? And it is effective …
The idea for conducting the research is here. Only we have to take into account that their results are always subject to the risk of error. We do not test the group of respondents with a lie detector, but we check whether they meet specific diagnostic criteria. In other words, the subject must admit that he has a problem. And admitting to alcoholism with doctors is very difficult … And not only with them.
Who else has the words: I’m an alcoholic stuck in the throat? Clergy?
It is said that the three most difficult professions to work in therapy are doctors, priests and lawyers, i.e. professions whose representatives very often and very strongly rationalize. A doctor can always say to himself: I am a doctor, I know the symptoms, I know the limit. I don’t drink when I am forced to, I drink to relax.
Although they know how it works, they apply a system of illusions and denials?
Yes, but it doesn’t have all the elements. Most often they minimize, or minimize, their drinking. They say: it’s not a big problem, I still have control over it, I have to “reset”. Blame is less common. They don’t blame it on a bad wife or a bad boss. If anything, it is due to stressful work, exhaustion, excess responsibilities. One of my patients told me that when he comes back at 22.00 p.m. he needs to recover quickly. He would drink three beers, lie down and fall asleep.
Are physicians of certain specialties more at risk than others? Are they talking about surgeons, anesthesiologists, cardiologists?
There were doctors of various specialties in the center where I worked. The claim that alcoholics are the highest among surgeons is a stereotype based on a difficult work environment. Responsibility, stress, emotions, concentration – if someone is unable to react in a healthy way, they can relax by taking shortcuts.
- See also: Alcoholism is more common among surgeons?
So how does a Polish doctor drink? Is he a typical high-functioning alcoholic or is he more of a “binge drinking”, or drinking in excess on weekends?
In fact, the way doctors drink is due to factors that make people vulnerable to addiction. In the case of doctors, we can name at least three.
The first is the high level of stress resulting from the very essence of work. The second will be overwork – we are talking about a professional group working very intensively – several jobs, overtime, additional shifts. The third factor is easy access to various substances, mainly drugs today.
However, let us not forget that in the times of the People’s Republic of Poland, cognacs and whiskey were available in Pewex as a model attachment for the “Doctor”. In short, the doctors had alcohol for free, in abundance, and of good quality – this in itself creates a kind of temptation. And now it is the background of the development of addiction that defines the way they drink.
When an overworked and stressed doctor comes home in the evening, alcohol is the “something” that gives him “quick relaxation”. He will drink two or three beers and already feel a little relaxed, distant and fall asleep. So very often this pattern of drinking is such that he drinks a small amount of alcohol every day “to relax” during the week, and the more intense drinking occurs at the weekend.
Now times have changed and it is very rare for doctors to drink during working hours or come to the hospital under the influence of alcohol – the risk is too great. They know very well that there will be a scandal, the police will come, and in the press they will go to the column “caught red-handed”. Consequently, they drink as per the schedule and keep their finger on the pulse.
One of my patients always had a breathalyzer with him – if he drank in the evening, he checked himself in the morning. Depending on the result of the measurement, he decided whether he could go to work or not. If he couldn’t, he called and explained that something important had happened to him …
From what the professor says, doctors are in a sense in control of the addiction.
This type of control is typical of high functioning alcoholics, but that doesn’t mean they don’t have a problem. Anyway, as addiction develops, weekend drinking becomes more and more difficult to control.
The last day of the congress, dinner with wine – the doctor / alcoholic will go with friends or with a mini bar in the hotel room?
It is possible, but not necessarily – it is still exposed to the assessment of the environment. Such a person may drink a small dose at a congress, but will “improve” when he returns home. High-functioning alcoholics usually drink alone, that is, lead a kind of “double life”.
- Also read: How is alcoholism treated?
Do doctors try to heal themselves?
Yes – most often with pharmacological agents. Sometimes it is disulfiram in the form of tablets or wafers, sometimes it is a new generation of drugs.
What must happen for a doctor to go to therapy?
In this case, there is no difference between doctors and other high-functioning alcoholics. These can be different situations: ultimatums given by a partner, family breakdown, strong withdrawal symptoms, loss of driving license, feedback under the title: you fail your job. That is, an external or internal crisis that forces you to reflect.
And a medical error? Have you had such patients?
No, I haven’t come across this. However, a distinction must be made between the medical error and the malaise caused by a “hangover”. We agree that such a feeling also influences the level of performed work… And many patients, doctors, talk about such conditions.
My guess is that doctors choose private centers …
Mostly yes.
Group A.A. not an option?
The literature talks about barriers, this is one of them. A physician will be reluctant to go to an AA meeting in a smaller town, where he will meet his patients, as will a priest who will meet his parishioners. It is very difficult for such groups – some go to meetings in other cities, others attend meetings organized in private centers. They make various attempts.
In Krakow, AA was established only for doctors, but the patent was not accepted. It seems that doctors are ashamed not only of their patients but of themselves.
The problem is how we view the alcohol problem. In the public consciousness, it is still the result of weak will, not a disease. After all, we have known for many years that alcohol addiction is a disease of the central nervous system. Two people can drink the same amount – and one of them will get addicted and the other will not, which is neither an advantage nor a disadvantage. Let’s ask ourselves: would a group of parkinson’s doctors also arouse similar emotions in us?
This is a good example. Both are potential threats to the patient. Both are sick.
Alcoholism is a shameful disease, and yet many people have broken taboos abroad and in Poland: prof. Zbigniew Religa, Bolesław Piecha, oncologist Maciej Frąckowiak.
- We recommend: The first symptoms of alcoholism may be difficult to recognize
“Coming out” does not have to be synonymous with professional death?
Of course not. Unfortunately, many people perceive it on the basis of their own imperfection: how could I slide to the bottom? Personally, I think that not every addict has to tell everyone about their problem. The main goal is to find a way to “function normally” in a state of abstinence.
We have doctors’ coming out, but not doctors. Although research shows they drink too …
I had such patients and I must admit that accepting alcoholism was very difficult for them, firstly because of the profession, and secondly because of their gender. Sometimes they only confessed to their loved ones.
During the pandemic, the doctors found themselves on the front lines, for the first months they did not even have ammunition. They said directly that the stress is overwhelming them … Forecasting: the problem of medics drinking “relaxation” can get worse?
Hypothetically, we could say that. Our research showed that during the most severe worsening of the pandemic, alcohol consumption was increased by those who drank more previously. However, we must take into account that not every person who drinks harmful or risky is addicted. On the other hand, among harmful or risky drinkers, a certain group becomes addicted, i.e. begins to meet certain diagnostic criteria.
History shows that we use psychoactive substances more often during crises. The Lord decided to check whether we emptied the home bar with COVID …
Indeed, many studies to date have shown that in the face of dramatic situations: wars, natural disasters or economic crises, alcohol consumption increases. This was the case in 2001 after the attack on the World Trade Center, four years later in the case of Hurricane Katrina, and during the recession of 2007-2009.
In our study, we wanted to see if the coronavirus pandemic – an event so different from the crises we know and affecting billions of people around the world in various respects – is having an impact on the use of psychoactive substances. Especially that in many countries around the world there has been an increase in alcohol sales, which of course does not have to translate into an increase in consumption. In my place of residence, it was impossible to get the spirit, which was bought mainly for disinfection.
Nevertheless, the first stage of the study showed that the pandemic changed drinking habits by over 30%. subjects.
Yes, but not everyone drank more – people aged 18-25 drank less, which is associated with the closure of pubs and clubs in the first months of the pandemic. Let’s not forget that student life practically died out, and students left the dormitories and returned home under the control of their parents. Therefore, I am very curious to see what it looks like today.
On the other hand, actually about 14 percent. of the respondents declared increased alcohol consumption. However, these were people who drank risky before the outbreak of the pandemic and were characterized by worse mental well-being. I must point out that the group of people who took part in the study was selected using the snowball method and it is not a representative sample for Poles.
But we can talk about certain trends – among those who drink more, there are well-educated people in their 30s and … without children. Looks like having children is a protective factor?
It can be said that among people who are not addicted, having children helps to maintain abstinence. I think this is a manifestation of a mature parental attitude.
What surprised you the most?
In the course of the research, we used the method of the fear of death scale and, interestingly, it did not differentiate the respondents. So it was not the fear of death that caused the respondents to reach into the glass. It was more a question of tension, depression, anxiety, not being able to find a place for yourself or being in any other way.
- See also: What does isolation do to our body and psyche?
The first stage of research is behind us, and now we are waiting for the second.
I think we will know the results in September. We all agree that our psychological situation has changed. Half a year ago, overnight we were faced with the task of not leaving home, avoiding loved ones, and working remotely. Today we are used to wearing masks and disinfecting, and most of the restrictions have been lifted.
Is there a risk that people who drank more in the first months of the pandemic are addicted today?
Yes, that’s why we want to see what it looks like. Moreover, people who drank more reported worse mental well-being and a higher level of anxiety, anxiety and depression. And we all know that treating emotional states with alcohol is highly dangerous.
Are you a doctor with an alcohol problem, your loved one works in healthcare and has an alcohol problem? Share your story with us, we guarantee anonymity: [email protected]
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