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Navigating substance use in anesthesiology: How to get help

Tracy Young, MSNA, MBA, CRNA

As the misuse of both illicit and prescription medications continues to rise, anesthesia professionals are becoming a more integral part of the care team managing patients with substance use disorders.  

But what about the anesthesia providers themselves? Where do they turn to when they need help? 

In the high-stakes world of anesthesia—where split-second decisions can mean the difference between life and death—the prevalence of substance use among clinicians is a concerning reality. The stresses and demands of the profession can often times lead to turning to alcohol and drugs to cope.  

However, it's crucial to recognize that if you are an anesthesia provider dealing with substance use, support is available, and seeking assistance is a sign of strength and self-awareness.  


Is burnout to blame? 

According to the National Insitute of Health, the prevalence of burnout in anesthesiology is among the highest across all medical specialties, with 40% of providers reporting experiencing burnout. And that percentage climbs even higher in high acuity settings, with burnout rates close to 55%. 

The demanding nature of the job, long hours, exposure to traumatic events, high stress and the pressure to maintain patient safety are all contributing factors.  

Access to drugs 

Substance use poses unique risks for anesthesia providers with their readily available and easy-to-access medications—like sedatives, narcotics and other controlled substances—increasing the likelihood of drug diversion.  

Which medications are most frequently listed by anesthesia providers seeking treatment? Opioids, with fentanyl and sufentanil also topping the list.  

It’s been over two decades since Opioid Addiction in Anesthesiology was released with these findings, and yet, we haven’t moved the needle. Substance use still remains one of the biggest issues in the anesthesia profession.  


Where do we go from here? 

Many providers feel like asking for help will put them on the fast track to having their license revoked. And colleagues often don’t know that someone is struggling because healthcare providers are great at working under pressure—or it’s assumed sleep deprivation. But, signs of irritability, social isolation, lack of punctuality, excessive working hours, frequent bathroom breaks or declining personal hygiene can be telltale signs that something is off.  

Anesthesia clinicians need to feel empowered that if they speak up and ask for help, they will not ruin their career or reputation—and that they will have the time to get the help they need. 

Addiction does not discriminate against race, religion or degree obtained. The most recent statistics state that approximately 20% of all adults struggle with addiction. They must be met with the same compassion and care they give their patients.  

And because substance use can be chronic, the chances that providers in recovery will experience a release are high. In fact, according to recent studies in PubMed, when opioids are involved, relapse can be deadly, with the first relapse manifesting as death in up to 19% of cases. 

How clinicians can seek help for substance use 

Professional organizations like the American Society of Anesthesiologists (ASA) and the American Association for Nurse Anesthesiology (AANA) offer support services and peer assistance programs specifically tailored to the needs of anesthesia providers.  

At Essential Anesthesia Management, clinicians have confidential access to well-being resources. W2 clinicians can leverage the Employee Assistance Program (EAP) through Insperity. And 1099 clinicians with Essential have access to Avibra, a well-being app, with 24/7 well-being advisors available and the ability to sign-up for teletherapy.  

Lastly, the Substance Abuse and Mental Health Services Administration (SAMHSA) has a 24/7. 365 treatment referral and information service for individuals experiencing substance use or mental health concerns at 1-800-662-HELP (4357). 

By raising awareness, providing support and offering resources for recovery, we can work together to ensure the well-being of both patients and practitioners alike.  

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