Why the study?
Does the type of substance abused affect the success rate and safety of reentry into anesthesiology training programs for residents with a history of substance abuse?
Does the type of substance abused affect the success rate and safety of reentry into anesthesiology training programs for residents with a history of substance abuse?
Reentry into anesthesiology training for residents with a history of parenteral opioid abuse has a low success rate and a high risk of death from relapse, suggesting redirection to another specialty may be safer.
Lower reentry success and elevated mortality risk appear linked to parenteral opioid abuse; leaves open whether redirection improves outcomes pending prospective studies.
To determine incidence and outcome of reentry into anesthesiology training programs by residents with histories of substance abuse, a survey was sent to the 159 US anesthesiology training programs. One hundred thirteen (71%) responded, with 82 (73%) submitting at least one case report of substance abuse. A total of 180 case reports were submitted, including 26 in which the resident died as a result of substance abuse. The prevalence of substance abuse among trainees was 2%. Sixty-one (74%) of the responding training programs submitted a total of 113 case reports of resident reentry into anesthesiology training. The success rate of reentry in the parenteral opioid abuser group was 34% (27/79). The success rate of reentry for the nonopioid abuser group was 70% (16/23). There were 14 cases of suicide or lethal overdose among trainees who were allowed to reenter anesthesiology training. Death as the initial relapse symptom occurred in 16% (13/79) of the parenteral opioid abusers who were allowed to reenter anesthesiology training. This study suggests that drug rehabilitation followed by redirection into another specialty may be the most prudent course for the anesthesiology trainee who abuses parenteral opioids.
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Emil J. Menk (1990) studied this question.
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