Problematic alcohol use among physicians is on the rise, but its true prevalence is unknown

December 14, 2022

2 minute read

Disclosures:
Wilson reports no financial disclosures. Please see the study for all relevant disclosures by other authors.


We have not been able to process your request. Please try again later. If you continue to have this problem, please contact customerservice@slackinc.com.

Problematic alcohol use among physicians appears to be on the rise, but self-reported studies rule out the true prevalence in the profession, the researchers say.

“Problematic alcohol use among physicians poses a serious concern to physicians’ health and their ability to provide care. Understanding the extent and characteristics of physicians with problematic alcohol use will help inform interventions,” Janet Wilson, medical student at the University of Ottawa, and his colleagues wrote in Open JAMA Network.

AdobeStock_135194028_1200X630_AND

Problematic alcohol use among physicians appears to be on the rise, but self-reported studies rule out the true prevalence in the profession, the researchers say. Source: Adobe Stock

The researchers conducted a systematic review to better understand how problematic alcohol use is for physicians, and how it may vary by characteristics such as age, specialty, and gender.

For their review of the evidence, Wilson and colleagues included studies that assessed problematic drinking using validated tools, such as the CAGE (Cut down, Annoyed, Guilty and Eye-opener) questionnaire, the Identification of Alcohol Use Disorders (AUDIT) and the C version of AUDIT (AUDIT-C).

The researchers included 31 studies in 17 countries that were published between January 2006 and March 2020. A total of 51,680 participants were involved in the studies – all of which had designs that were self-reported cross-sectional surveys.

Wilson and colleagues found that regardless of measurement method, “problematic drinking varied widely (0% to 34% with AUDIT; 9% to 35% with AUDIT-C; 4% to 22% with CAGE)”.

From 2006 to 2010, reported problem alcohol consumption was 16.3%. From 2017 to 2020, the prevalence jumped to 26.8%. However, “it remains unclear whether this increase is indeed accurate or whether it is due to increased transparency by physicians in self-reporting of problematic alcohol use due to a changing medical culture.”

Nineteen studies examined the extent of problematic drinking by gender, and seven of these – 37% – “identified that problematic drinking was more common in men than in women” .

“Based on the high heterogeneity of methods of the included studies, limited conclusions can be drawn about how problematic drinking varies by age, sex, specialty, and career stage of the doctor,” the researchers warned.

One of the difficulties noted by the researchers was that “the definition of what constituted a positive screen for problematic alcohol use varied considerably between studies”. Additionally, they noted that “most studies reported low response rates,” suggesting that physicians might “be hesitant to participate in studies assessing problematic alcohol use.”

“Physicians who use alcohol-related screening questionnaires as part of their practice may be familiar with the scoring systems and may respond in ways that screen negative for problematic alcohol use. Physicians may be susceptible to underreport use for fear of retaliation from colleagues and licensing boards,” they wrote. “Therefore, the low levels of problematic drinking identified in this review underreport probably the extent and consequent harm of alcohol consumption by physicians.”

The researchers concluded that “studies of problematic alcohol use among physicians demonstrate a high degree of heterogeneity in terms of measurement methods, definitions of problematic alcohol use, and the cohorts assessed.” Additionally, they noted that since most studies are primarily self-reported, the ability to determine true prevalence within the profession is precluded.

“Cultural changes that minimize stigma and reduce barriers to help-seeking can encourage doctors who are suffering in silence to seek help. Future research may also aim to better understand the factors that limit physician disclosure of problematic alcohol use and ultimately deconstruct these factors to promote care-seeking behavior among physicians,” wrote Wilson and these partner’work. “Additionally, a better understanding of gender, age, medical specialties, and career stages most at risk for problematic alcohol use would help inform the development of physician health programs that identify problematic alcohol use. alcohol and establish timely interventions for those in need.”

The US Addiction Centers offer resources specifically for doctors in need, and there are a number of confidential ways to contact them and learn more about treatment: visit this page or call (866) 685-9481.

Leave a Comment