Substance Abuse A Culture Of Denial 002



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Substance Abuse: A Culture of Denial


Bartram and David Baldwin FRPCPsych (no relation to Barbara Baldwin), University of Southampton School of Medicine in Hampshire, U.K., recently released a study of veterinary suicide rates and substance abuse issues. It was published in the U.K. journal Veterinary Record.

Bartram and Baldwin’s research pulled from several other studies that surveyed different facets of the medical profession. Once the statistics were compiled, Bartram said he knew he wanted to conduct a more comprehensive study on U.K. veterinarians’ mental health.

“Although compassion fatigue is not a term we use in the U.K., we do look at veterinary job-related stress and find that plays a role in mental distress,” Bartram said.

Job stress, lethal drug access and euthanasia acceptance are among the potential driving forces behind U.K. veterinarians’ heightened risk for substance abuse and suicide, Bartram and Baldwin said.

“The study, which encompasses UK veterinarians’ depression, suicide, alcoholism and working conditions, is expected to be complete at the end of this summer,” Bartram said. “I received a 56 percent response rate out of 3,200 questionnaires sent out.”

Of the lack of a wellness plan for U.S. veterinarians, Bartram said, “Considering many of these issues are concealed, there is no way to conclude what the importance of the issue is in the States without answers to specialized questions in a comprehensive survey.
This will give a starting point for action.”

Since 1999, the United Kingdom has had a well-developed program sponsored through the British Veterinary Association (BVA), and the Veterinary Benevolent Fund (VBF), among other sponsors.

The website, run by VBF, reports in the Veterinary Surgeons Health Support Program’s 2006 annual report that 39 new veterinary practitioners were treated in the program. Nineteen of the participants were female and 20 were male. The report also shows that 48 percent of veterinarians in the program were referred by colleagues and 41 percent were under the age of 30.

The Veterinary Benevolent Fund assists veterinary surgeons unable to work as a result of ill health. It also helps dependents of deceased veterinary surgeons, retired veterinary surgeons and veterinary surgeons and their dependents needing short-term assistance. The program provides a help hotline, which can be called for support or direction.

The Veterinary Surgeons Health Support Program was created to combat problems of alcohol, drugs, eating disorders and other addictive and mental health issues among its members. The program is based on similar options available to members of the U.K. dental and pharmaceutical professions.

The U.K.’s proactive approach to spark awareness is what is necessary in the U.S., according to Hall and Williams.

“Those working within the profession overlook signs that indicate a problem exists, either because they’re not educated in what the signs are, they do not want to seem like a tattle-tale or they simply do not want to get involved,” Hall said. “The person calling an agency to help another suffering from an addiction is saving their life.”

The difference between veterinarians and MDs is that vets are more isolated, Hall said.

“There are many more outlets for MDs, whereas in a small-animal practice, no one sees the problem and it persists,” Hall says. “It’s especially easy for equine practitioners to acquire an ample supply of codeine, considering horses take ten times the dose of a human. I could write off the medication as an equine cough syrup.”

The U.S. Substance Abuse and Mental Health Services Administration estimated the general population’s substance abuse rate at 8.8 percent in a 2002-2004 survey, while the Centers for Disease Control rated the general population’s rate at 8.1 percent in 2005.

In a 1992 report about alcohol and substance abuse and impairment among physicians, the National Institute of Health’s National Center for Biotechnology Information said that high substance abuse in the medical profession is an ”occupational hazard.” Although societal concerns surrounding substance abuse and mental health issues persist, the issue has been acknowledged as an area where MDs need assistance, but veterinarians wait for that national recognition.

Williams has been in practice since 1969 and said his recovery from an opiate addiction has been extremely difficult and remains an ongoing process. Williams said he hasn’t used opiates since 1992 and added that while support isn’t available within the profession, it is essential for recovery and mental success.

“I do not feel the profession’s attitude reflects a ‘Let-me-help-you persona,’” he said. “It’s more of an overwhelming impression that ‘I am an isolated case,’ and that’s not the case. This is apparent by the lack of U.S. data, the lack of discussion, the lack of assistance.”

Inside Job
“Most veterinarians don’t remain vigilant over narcotics records,” Williams noted. “It is a difficult thing to police. Veterinarians trust their staff and vice versa. No one goes into a position expecting someone to be stealing animal drugs. However, most of the time when drugs are reported missing from a veterinary practice, it was an inside job.”

Universities
“If we don’t begin making an effort at the university level, generation after generation will be introduced to the profession, unprepared to deal with this,” Williams said. “The issue goes beyond addictions. It is also mental issues and compassion fatigue.”

Williams said the Alabama Veterinary Professional Wellness Program will ask the Alabama Board of Examiners to include the organization’s wellness survey with the annual veterinary license renewal done in December. The organization also plans to survey the school this fall if the schools agree to implement it.

“We’ve been trying to get more involved with the veterinary schools on these issues, but we’re having a really hard time getting them to accept that there is a problem to be addressed,” Skipper said. “We were recently invited to speak at the annual SCAVMA meeting at Auburn and only one person showed up for the lecture. This denial is a cultural phenomenon [among veterinarians].” n

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