Substance Abuse A Culture Of Denial 001
“If doctors can come forward without being stigmatized or criminalized, they tend to want to stay away from the boards,” Skipper said. “But the boards [should] want [a wellness program] from an early prevention stand point.”
In states without rehabilitation and monitoring programs, a veterinarian or veterinary technician would be able to enroll in a treatment facility without reporting it to the board. In this case, the board could not regulate its licensees or impose sanctions if necessary for possible licensing violations based on the impairment, according to the Indiana Board of Veterinary Medical Examiners.
Part of why Alabama’s veterinary wellness program is successful may be the collaboration between the ALVME and the state VMA, which allows impaired veterinarians to come forward without risk of losing their practice or their license.
“What gets success is monitoring,” Skipper said.
“Vets sign a contract when they get out of recovery that holds them accountable for their recovery process. Also, we can advocate on their behalf if we need to, to licensing boards, etc., for example if they want to relocate to another state for a job. We encourage them never to lie on an application about a mental illness or substance abuse problem.”
“Not reporting to the board poses a problem as far as animal welfare is concerned,” Hall said. “I improperly sutured a Doberman puppy’s Achilles tendon when I was drunk. I had already gone through a rehabilitation facility in Minnesota when the veterinary board approached me about possible malpractice. I was honest about my actions, but I decided to leave general practice.”
Society tends to view any addiction as a defect, Hall said.
“Once you cross the line with an alcohol addiction, there’s no such thing as social drinking,” he noted. “After more than a decade of sobriety, I crashed and burned. Addictive disease characteristics are eloquent, and require support and that should be available through AVMA no matter where you live. I know if I relapse again, I will die.”
Hall said he found working around controlled substances to be very difficult as an addict.
“As an equine practitioner, I found myself filling prescriptions for an equine patient that didn’t need medicating,” Hall said. “Instead, I used the drugs myself. I knew I needed help after the Doberman incident. I knew I couldn’t keep it up in practice much longer.”
Existing state-based veterinary programs are handled differently in each state. Some programs are run through the state VMA, others through the board of veterinary medical examiners or through a combined program that includes other medical professionals. Hall said this complicates an already difficult situation.
“In 2005, AVMA sunset the Wellness Committee and their charge was transferred to the Member Services Committee,” said Sharon Granskog, assistant director of media relations for AVMA. “MSC has a goal of positioning the association as a resource for state and local veterinary leaders to provide wellness programs that best serve veterinarians and their communities.”
This past August, the member services committee developed a survey designed for state VMAs to determine which resources and types of programs would most benefit their members.
“Results of the survey indicated that 66.7 percent of those who responded said Employee Assistance Programs should be handled through the state,” Granskog said. “While 33.33 percent believe AVMA should handle the programs, 28.57 percent believe programs should be handled through the employer and 4.76 percent believe a program is unnecessary.”
Granskog did not detail how many responses were received.
Some contend that a national monitoring program would still be beneficial.
“This doesn’t address whether the VMAs would use a program designed and implemented by the AVMA,” Williams said. “The problem is, no one thinks about the need for a program until there is an immediate need. Only ignorance allows a person to say there isn’t a problem. They just don’t know who has the problem.”
Granskog said the member services subcommittee believes that wellness and peer assistance are issues crucial to the well being of the veterinary profession and would be best addressed by associations closest to the veterinarians who need assistance. But the AVMA’s website implies a more proactive approach than what has been delivered.
Barbara Baldwin, assistant director of the AVMA’s membership and field services division, said the association has no statistical information on these issues.
“AVMA does not have statistics on veterinary substance abuse or mental health,” she said, “We do not have a person assigned to keep the data updated, but it could eventually be part of a staffer’s job.”
AVMA reviews councils and committees every year, Baldwin said, noting that the Wellness Committee was discontinued because it no longer served members’ best interests.
“Since Employee Assistance Programs are out there as a benefit employers can offer employees, AVMA believes making a substance abuse program available to the 76,000 practicing veterinarians would be cost prohibitive,” she said.
“The MSC has a lot on its plate. We still have to look at what would best serve our members in this area. Any time you have a medical professional with access to medications, this is an issue. We haven’t had time to look at U.S. info for this to see what AVMA should do to best serve its members. We have a list of contacts on the AVMA website, but it is outdated and we don’t have contacts for some states.”
In 2003, AVMA’s Wellness Committee created a model wellness program that addresses addiction for states to consider. Those guidelines will be reviewed in 2009, according to AVMA, and currently appear online and annually in AVMA directories.
“We do not know what form AVMA will assist members with this topic, but we are investigating what resources we can provide,” Baldwin said. “Right now there is no plan for AVMA to implement a substance abuse/mental health plan for veterinarians. We see the AVMA as a clearinghouse of information in this instance. I hope to update the information on this topic on AVMA’s website over the next year.”