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Intensive inpatient treatment and subsequent follow-up care increases possibility of recovery for healthcare professionals with substance use disorder. Upon completion of a rehabilitation program, a safe return to work in anesthesia can be facilitated on an individual basis. Not all practitioners will be able to return to practice. Reentry challenges an anesthesia professional may encounter include stigmatization, shame, working with choice substances, and unresolved pain, all contributing to the threat of relapse.
Readiness for reentry is a collaborative decision of the monitoring program, a certified drug and alcohol counselor, and the employer. A minimum of one year in recovery before returning to the clinical anesthesia arena is recommended. The following criteria should be met prior to considering re-entering practice:
- Evaluation by a licensed provider with experience treating substance abuse and dependency
- Successful completion of a rehabilitation program
- Acceptance of the chronic nature of substance use disorder
- Evidence of a supportive spouse, significant other, or other supportive individuals
- Willingness to take Naltrexone, if appropriate, under direction and supervision of medical professional
- Having no untreated psychological comorbidities
- Participation in a monitoring program with random drug testing
- Recovery is improved when random drug testing occurs because of the consequences of a positive test
- Five-year duration of monitoring with the potential of monitoring for the duration of clinical practice
- Having supportive colleagues, especially administrators and supervisors, at worksite familiar with history and needs
- Grounding in a recovery community, such as Anesthetists In Recovery
- Participating in a 12-step program
Because anesthesia professionals are engaged in safety-sensitive work with considerable consequences when errors occur, abstinence-based recovery and refraining from substitute treatments such as buprenorphine are recommended.
Additional information on disclosure and return to work contracts and relapse prevention.
Source: Addressing Substance Use Disorder for Anesthesia Professionals position statement and policy considerations (www.AANA.com/AddressingSUD)
See also Recommendations for the Treatment of the Disease of Addiction in Anesthesia Professionals and Students